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Association Between Postoperative Hyperglycemia and Mortality in Pediatric Elective Craniotomy

Xin Cheng1, Yu Zhang2, Huiwen Tan3

  • 1Department of Neurosurgery.

Journal of Neurosurgical Anesthesiology
|February 13, 2026
PubMed

Insights

Severe hyperglycemia after pediatric craniotomy significantly increases the risk of mortality in children. This finding highlights the importance of monitoring blood glucose levels in these young patients post-surgery.

Area of Science:

  • Pediatric Neurosurgery
  • Critical Care Medicine
  • Endocrinology

Background:

  • Hyperglycemia is common in pediatric neurosurgical patients.
  • The impact of postoperative hyperglycemia after pediatric craniotomy is not well understood.
  • This study investigates the link between postoperative hyperglycemia and mortality in children undergoing craniotomy.

Purpose of the Study:

  • To determine the association between postoperative hyperglycemia and mortality in pediatric patients after elective craniotomy.
  • To analyze the impact of hyperglycemia severity on mortality outcomes.
  • To explore secondary outcomes such as morbidity and hospital stay.

Main Methods:

  • Retrospective, single-center study of 1309 pediatric patients undergoing elective craniotomy.
  • Multivariable regression analysis to identify associations between hyperglycemia and mortality.
  • Defined mild hyperglycemia (8.3-11.1 mmol/L) and severe hyperglycemia (>11.1 mmol/L).
  • Primary outcome: 90-day mortality. Secondary outcomes: 30-day mortality, composite morbidity, prolonged hospital stay.

Main Results:

  • Severe hyperglycemia was present in 6.0% of patients, mild in 15.1%.
  • 90-day mortality was 24.1% in severe hyperglycemia vs. 5.0% in normoglycemia.
  • Severe hyperglycemia significantly associated with increased 90-day mortality (aOR 3.65).
  • Severe hyperglycemia also linked to greater morbidity and longer hospital stays.
  • No association found in children under 5 years.

Conclusions:

  • Severe postoperative hyperglycemia is a significant risk factor for mortality in children undergoing elective craniotomy.
  • The findings underscore the need for vigilant glucose monitoring and management in pediatric neurosurgical patients.
  • Further research may explore targeted interventions for hyperglycemia in this population.
Abstract

Keywords:
elective craniotomyhyperglycemiamortalitypostoperative period

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