title: Evaluation of serial C-reactive protein measurements after surgical treatment of pleural empyema.
abstract: OBJECTIVE
  Serial C-reactive protein measurements have been used to diagnose and monitor the response to therapy in patients with pneumonia and other infectious diseases. Nonetheless, the role of C-reactive protein measurement after surgical treatment for pleural empyema is not well defined. The aim of this study is to describe the behavior of C-reactive protein levels after the surgical treatment of pleural empyema and to correlate this parameter with the patient's prognosis.
  
  
  METHODS
  We retrospectively analyzed the records of patients with pleural empyema treated by either chest-tube drainage or surgery from January 2006 to December 2008. C-reactive protein levels were recorded preoperatively and 2 and 7 days postoperatively. The clinical outcome was binary: success or failure (mortality or the need for repeated pleural intervention).
  
  
  RESULTS
  The study group comprised fifty-two patients. The median C-reactive protein values were as follows: 146 mg/L (pre-operative), 134 mg/L (post-operative day 2), and 116 mg/L (post-operative day 7). There was a trend toward a decrease in these values during the first week after surgery, but this difference was only statistically significant on day 7 after surgery. Over the first week after surgery, the C-reactive protein values decreased similarly in both groups (successful and failed treatment). No correlation between the preoperative C-reactive protein level and the clinical outcome was found.
  
  
  CONCLUSIONS
  We observed that, in contrast to other medical conditions, C-reactive protein levels fall slowly during the first postoperative week in patients who have undergone surgical treatment for pleural empyema. No correlation between the perioperative C-reactive protein level and the clinical outcome was observed.
authors.affiliation: Messejana Hospital, Fortaleza, CE, Brazil.
authors.forename: Israel Lopes
authors.initials: IL
authors.lastname: Medeiros
authors.forename: Ricardo Mingarini
authors.initials: RM
authors.lastname: Terra
authors.forename: Esther Mihwa
authors.initials: EM
authors.lastname: Choi
authors.forename: Paulo Manuel
authors.initials: PM
authors.lastname: Pego-Fernandes
authors.forename: Fabio Biscegli
authors.initials: FB
authors.lastname: Jatene
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D004322:Drainage / Q000379:methods; D016724:Empyema, Pleural / Q000097:blood* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein