Utility of C-reactive protein measurements for empyema diagnosis after pneumonectomy.
Ann Thorac Surg
; 57(4): 933-6, 1994 Apr.
Article
em En
| MEDLINE
| ID: mdl-8166544
ABSTRACT
Serum C-reactive protein (CRP) levels were studied serially during the postoperative period in 151 consecutive patients who underwent pneumonectomy. Virtually all patients who had a simple postoperative course (115 of 120), as well as 9 patients who had a bronchial infection of the remaining lung, 3 with a pulmonary embolus, and 2 who suffered postoperative bleeding requiring reoperation, demonstrated a similar postoperative evolution in their CRP values a rapid postoperative rise until a peak or a plateau (mean peak value, 132 +/- 25 mg/L) was reached within 3 to 6 days, followed by a progressive decline to a value of less than 75 mg/L on day 9, and less than 50 mg/L on day 12. Conversely, all 12 patients who suffered empyema postoperatively, as well as 3 patients with bacterial pneumonia, 1 patient with chylothorax, and 1 patient with inflammatory pericarditis, demonstrated either a markedly persistent elevation in their CRP values or a secondary rise in the levels which exceeded 100 mg/L. Because of the high sensitivity (100%) and specificity (91.4%) of the CRP levels in detecting postpneumonectomy empyema, we recommend the routine use of this measure. Furthermore, a low CRP value after pneumonectomy (less than 50 mg/L) may help in deciding whether to confidently discharge a patient from the hospital in the absence of empyema. The negative predictive value of this method was found to be 100%.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonectomia
/
Proteína C-Reativa
/
Empiema Pleural
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Prognostic_studies
Limite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Ann Thorac Surg
Ano de publicação:
1994
Tipo de documento:
Article
País de afiliação:
França