Impact of Severe Intraoperative Hyperglycemia on Infection Rate After Elective Intracranial Interventions

Study Overview
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Brief Summary
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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.

Official Title
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Impact of Severe Intraoperative Hyperglycemia on Infection Rate After Elective Intracranial Interventions

Conditions
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Hyperglycemia, Craniotomy, Infection Post Op

Intervention / Treatment
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* Procedure: Intracranial Interventions


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Intracranial Interventions|Neurosurgical elective intracranial interventions: supra- and infratentorial craniotomies, transnasal endoscopic interventions.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Infection rate | Proportion of patients diagnosed with infection (wound, pulmonary, urological, blood etc.) in the postoperative period according to CDC. | 7 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Antibiotic prophylaxis | Antibiotic usage for prevention of postop infection: type and dosage | Preoperatively | 
| Glucose level | Intraoperative glucose level in whole blood | Twice intraoperatively: before incision and at the end of surgery | 
| History of steroids usage | Dosages and regimen of dexamethasone in the perioperative period | Preoperatively | 
| Insulin dosage | Intraoperative dose of insulin | Intraoperatively | 
| Complications | Perioperative complications (episodes of hemodynamic instability, blood loss, etc.) | Intraoperatively | 
| Duration of stay in ICU and hospital | Length of stay in ICU (in hours) and in hospital (in days) after surgical intervention | 30 days | 
| Treatment outcome | Outcome at the moment of discharge (improved,unchanged, worsened, death) | 30 days |