Craniotomy, Hyperglycemia, Infection Post Op
Conditions
Brief summary
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.
Interventions
PROCEDUREIntracranial Interventions
Neurosurgical elective intracranial interventions: supra- and infratentorial craniotomies, transnasal endoscopic interventions.
Sponsors
Burdenko Neurosurgery Institute
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult patients (\>18 years) scheduled for elective intracranial (open or endoscopic) intervention.
Exclusion criteria
Diagnosis of infection (local or systemic) in preoperative period; urgent intervention.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Infection rate | 7 days after surgery | Proportion of patients diagnosed with infection (wound, pulmonary, urological, blood etc.) in the postoperative period according to CDC. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Glucose level | Twice intraoperatively: before incision and at the end of surgery | Intraoperative glucose level in whole blood |
| History of steroids usage | Preoperatively | Dosages and regimen of dexamethasone in the perioperative period |
| Insulin dosage | Intraoperatively | Intraoperative dose of insulin |
| Antibiotic prophylaxis | Preoperatively | Antibiotic usage for prevention of postop infection: type and dosage |
| Duration of stay in ICU and hospital | 30 days | Length of stay in ICU (in hours) and in hospital (in days) after surgical intervention |
| Treatment outcome | 30 days | Outcome at the moment of discharge (improved,unchanged, worsened, death) |
| Complications | Intraoperatively | Perioperative complications (episodes of hemodynamic instability, blood loss, etc.) |
Countries
Italy, Russia
Outcome results
None listed