Evaluation of serial C-reactive protein measurements after surgical treatment of pleural empyema

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.