Association Between Postoperative Hyperglycemia and Mortality in Pediatric Elective Craniotomy

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.