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Preoperative C-reactive protein predicts the need for repeated intracerebral brain abscess drainage


Neidert, M C; Karlin, K; Actor, B; Regli, L; Bozinov, O; Burkhardt, J K (2015). Preoperative C-reactive protein predicts the need for repeated intracerebral brain abscess drainage. Clinical Neurology and Neurosurgery, 131:26-30.

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) (13.9mg/l vs. 56.1mg/l, p=0.015) was significantly higher in the M group. Preoperative mean leukocyte count (12.3×109/l vs. 8.9×109/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.
DISCUSSION: 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.

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) (13.9mg/l vs. 56.1mg/l, p=0.015) was significantly higher in the M group. Preoperative mean leukocyte count (12.3×109/l vs. 8.9×109/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.
DISCUSSION: 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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:C-reactive protein (CRP); Intracerebral brain abscess; Repeated surgical drainage
Language:English
Date:24 January 2015
Deposited On:15 Feb 2016 14:07
Last Modified:09 Apr 2017 05:41
Publisher:Elsevier
ISSN:0303-8467
Publisher DOI:https://doi.org/10.1016/j.clineuro.2015.01.015
PubMed ID:25666764

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