title: Preoperative C-reactive protein predicts the need for repeated intracerebral brain abscess drainage.
abstract: BACKGROUND
  To determine predicting factors for repeated surgical drainage in patients with intracerebral brain abscesses.
  
  
  METHODS
  Patients operated between 01/2008 and 10/2013 with a single-burr-hole technique to drain an intracerebral brain abscess were included from our prospective database. Clinical and radiological characteristics were analyzed retrospectively and compared between patients requiring a single surgical abscess drainage (S group) vs. patients requiring multiple surgical abscess aspirations (M group).
  
  
  RESULTS
  Thirty-five patients (mean age 42.6 years, 14 females) including 27 patients in the S group and 8 in the M group were included in this study. Age, gender, causing bacterial agent, surgical technique and abscess volume were comparable for both groups. Preoperative mean C-reactive protein (CRP) (13.9 mg/l vs. 56.1 mg/l, p=0.015) was significantly higher in the M group. Preoperative mean leukocyte count (12.3×10(9)/l vs. 8.9×10(9)/l, p=0.050) was borderline significantly higher in the M group. Although the origin in the overall population was cryptogenic in 43% of the cases, this was never the case in the patient population needing multiple surgeries.
  
  
  CONCLUSIONS
  Patients with multiple intracerebral brain abscess aspirations showed significantly higher preoperative CRP values than patients who needed surgery only once. Patients with high CRP values at admission and obvious origin of infection might need closer radiographic as well as clinical and laboratory exams after surgery to earlier select patients, which need repeated surgery.
authors: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors: Marian C
authors: MC
authors: Neidert
authors: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors: Kirill
authors: K
authors: Karlin
authors: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors: Bertrand
authors: B
authors: Actor
authors: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors: Luca
authors: L
authors: Regli
authors: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
authors: Oliver
authors: O
authors: Bozinov
authors: Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland. Electronic address: JanKarl.Burkhardt@gmail.com.
authors: Jan-Karl
authors: JK
authors: Burkhardt
mesh_terms: D000328:Adult; D001922:Brain Abscess / Q000097:blood / Q000473:pathology / Q000601:surgery; D002097:C-Reactive Protein / Q000032:analysis*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein (CRP); Intracerebral brain abscess; Repeated surgical drainage