Stress hyperglycemia and glycemic control in critical neurosurgical patients: A retrospective study

Abstract

Aim: The aim of this study was to determine the rate of stress hyperglycemia (SH) in non-diabetic critical neurosurgical patients and the effect of SH on patient outcomes, and to evaluate the glycemic control protocol applied in the neurosurgical intensive care unit (ICU).Material and Methods: The sample of this retrospective study was the files of patients who had been admitted for at least three days to the neurosurgical ICU of a university hospital in Istanbul, Turkey, who were not diabetic, and who were aged 18 years or more. Data collection was performed with a data collection form developed by the researchers in line with the literature, and by examining the patients’ files. Before commencing the study, permission was obtained from the ethics committee.Results: The mean age of the patients was 55.74 years, and a majority (62.2%) was male. SH was seen in 47.7% of the patients. The rate of SH was significantly higher in those with a Glasgow Coma Scale (GCS) score of below 13 and in those with intracranial hematoma or traumatic brain injury (p0.05). It was found that the blood glucose value of 91% of patients in the ICU remained within the target glycemic control range of 80-180mg/dl. It was found that 90% of patients who could not achieve glycemic control were patients who developed SH (p140 mg/dl), and in 73.7% of these were patients who developed SH (p0.05).Conclusion: The study showed that rates of SH are high in critical neurosurgical patients, and that in most of those developing SH, hyperglycemia continues while they are in the ICU.