Artikel
C-reactive protein and erythrocyte sedimentation rate following surgery for intracranial lesions
CRP und BSG Verlauf nach Kraniotomie zur intrakraniellen Operation
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Autoren
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M.J. Mirzayan
- Department of Neurosurgery, Medical School Hannover
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A. Gharabaghi
- Department of Neurosurgery, University Hospital, Tuebingen
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M. Samii
- International Neuroscience Institute Hannover
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M. Tatagiba
- Department of Neurosurgery, University Hospital, Tuebingen
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J.K. Krauss
- Department of Neurosurgery, Medical School Hannover
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S.K. Rosahl
- Department of Neurosurgery, Albert-Ludwigs-University, Freiburg
| Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) are considered indicators of an inflammatory process in the body. These parameters also respond to other irritations of the body such as a surgical intervention. While both are often measured in peripheral blood samples when a postoperative infection is suspected, data on their physiological course after intracranial surgery have been lacking.
Methods: CRP and ESR were measured prospectively in 48 patients (20 female, 28 male) who underwent craniotomy for elective intracranial microsurgery (26 supratentorial, 22 infratentorial).
Results: After surgery, CRP increased rapidly reaching a peak mean value of 31.80 mg/l (±37.33) on second postoperative day. This increase from the preoperative day to day two after surgery was highly significant (p<0.001) In 41 patients (85%) CRP reached its maximum level within the first two days after surgery. In the remaining 7 patients this peak occurred on the third postoperative day. From day three to day five following surgery, mean CRP values declined constantly and significantly (p<0.001) to reach a level of 6.44 mg/l (±10.63 mg/l) on the fifth postoperative day. On day four, mean CRP level had returned to below one third of the peak value (10.3±16.79). On an individual basis, this was true for 36 patients of the patients (78%). During the period of initial increase of CRP until the second postoperative day, there was no significant correlation between CRP levels and ESR, axillary body temperature, hemoglobin, hematocrit, RCC, platelet count, and WCC. CRP increase was more pronounced with intrinsic brain tumors and not correlated to the degree of malignancy of the lesions.
Conclusions: While the latency of ESR changes is too long to use this parameter reliably for the detection of infectious complications during the postoperative period, CRP reaches its peak values more rapidly and should normally return to one third of the maximum level on the fourth post-operative day. Therefore, CRP may be employed as an early, yet non-specific predictor of an inflammatory process following intracranial surgery.
