The Brain Tumor & Neuro-Oncology Center, Department of Neurosurgery, the Neurological Institute, Cleveland, Ohio, USA.
J Neurosurg. 2010 Aug;113(2):161-6. doi: 10.3171/2010.2.JNS09950.
In select patient populations, hyperglycemia has been shown to increase the risk of surgical site infection (SSI), whereas stringent glucose control has improved outcomes. To date, no study has focused on whether SSIs in patients with brain tumors undergoing resection are associated with hyperglycemia.
The authors performed a retrospective chart review of patients who underwent a craniotomy after receiving a diagnosis of brain tumor. From 2001 to 2008, 2485 patients underwent a craniotomy for tumor resection at the Brain Tumor & Neuro-Oncology Center at the Cleveland Clinic. Fifty-seven of these patients (2.3%) developed SSIs postoperatively. A matched case-control study design was used, with 57 patients who developed SSIs after craniotomy (cases) matched with 57 patients who did not develop SSIs (controls). The results were analyzed using both univariate and multivariate conditional logistic regression.
Glucose level was not a significant factor in postoperative SSI (p = 0.83) after adjusting for duration of surgery and adherence to antibiotic prophylaxis. However, duration of surgery was significantly associated with postoperative SSI (p = 0.047).
For patients who undergo craniotomy for definitive resection of a brain tumor, duration of surgery described more variation in the model to predict SSI than blood glucose levels.
在某些特定患者人群中,高血糖已被证明会增加手术部位感染(SSI)的风险,而严格控制血糖则可以改善预后。迄今为止,尚无研究关注接受肿瘤切除术的脑瘤患者的 SSI 是否与高血糖有关。
作者对在克利夫兰诊所脑肿瘤与神经肿瘤中心接受诊断后行开颅手术的患者进行了回顾性图表审查。2001 年至 2008 年间,共有 2485 名患者因肿瘤切除而行开颅手术。其中 57 名患者(2.3%)术后发生 SSI。采用病例对照研究设计,将 57 名术后发生 SSI 的患者(病例)与未发生 SSI 的 57 名患者(对照)进行匹配。使用单变量和多变量条件逻辑回归对结果进行分析。
在调整手术时间和抗生素预防措施的依从性后,血糖水平并不是术后 SSI 的显著因素(p=0.83)。然而,手术时间与术后 SSI 显著相关(p=0.047)。
对于因明确切除脑瘤而行开颅手术的患者,手术时间比血糖水平更能描述 SSI 预测模型中的更多变化。