Severe intraoperative hyperglycemia (SIH) is recognized as one of the important risk factors for the increasing of the postoperative infections rate, which can negatively affect the final outcome of surgical treatment. Studies in recent years have shown a much higher incidence of wound infections, respiratory and urinary tract infections in patients who intraoperatively had an increase in blood glucose level (BGL) above 180 mg/dl (10 mmol/l). This problem in neurosurgery is especially important due to the high proportion of patients with acute injuries and potentially long-term need for postoperative intensive care, as well as the frequent use of drugs that increase blood glucose level (steroids) in neurooncology. Most published studies include patients from both of these groups. This study is aimed to assess the impact of severe intraoperative hyperglycemia on the incidence of infectious complications only in patients scheduled for elective intracranial interventions.
Study Type
OBSERVATIONAL
Enrollment
514
Neurosurgical elective intracranial interventions: supra- and infratentorial craniotomies, transnasal endoscopic interventions.
Sapienza University of Rome
Roma, Italy
Federal State Autonomous Institution "N .N. Burdenko National Medical Research Center of Neurosurgery" of the Ministry of Healthcare of the Russian Federation
Moscow, Russia
Infection rate
Proportion of patients diagnosed with infection (wound, pulmonary, urological, blood etc.) in the postoperative period according to CDC.
Time frame: 7 days after surgery
Antibiotic prophylaxis
Antibiotic usage for prevention of postop infection: type and dosage
Time frame: Preoperatively
Glucose level
Intraoperative glucose level in whole blood
Time frame: Twice intraoperatively: before incision and at the end of surgery
History of steroids usage
Dosages and regimen of dexamethasone in the perioperative period
Time frame: Preoperatively
Insulin dosage
Intraoperative dose of insulin
Time frame: Intraoperatively
Complications
Perioperative complications (episodes of hemodynamic instability, blood loss, etc.)
Time frame: Intraoperatively
Duration of stay in ICU and hospital
Length of stay in ICU (in hours) and in hospital (in days) after surgical intervention
Time frame: 30 days
Treatment outcome
Outcome at the moment of discharge (improved,unchanged, worsened, death)
Time frame: 30 days
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