Hyperglycemia is independently associated with post-operative function loss in patients with primary eloquent glioblastoma

Abstract The poor prognosis for patients with glioblastoma (GB) heightens the importance of maintaining function throughout treatment. Hyperglycemia has been linked to poor neurological outcomes following stroke, traumatic brain and spinal cord injury. We hypothesized this may also be true following...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2012-07, Vol.19 (7), p.996-1000
Main Authors: Link, Thomas W, Woodworth, Graeme F, Chaichana, Kaisorn L, Grossman, Stuart A, Mayer, Robert S, Brem, Henry, Weingart, Jon D, Quinones-Hinojosa, Alfredo
Format: Article
Language:English
Subjects:
Age
Aged
Blood
Brain Neoplasms - surgery
Dexamethasone
Female
Function
Glioblastoma
Glioblastoma - surgery
Glucose
Humans
Hyperglycemia
Hyperglycemia - etiology
Male
Middle Aged
Nervous system
Neurological diseases
Neurology
Postoperative Complications - physiopathology
Prognosis
Rehabilitation
Retrospective Studies
Spinal cord injury
Statistics, Nonparametric
Stroke
Time Factors
Traumatic brain injury
Tumors
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Summary:Abstract The poor prognosis for patients with glioblastoma (GB) heightens the importance of maintaining function throughout treatment. Hyperglycemia has been linked to poor neurological outcomes following stroke, traumatic brain and spinal cord injury. We hypothesized this may also be true following the resection of GB. We assessed associations with post-operative function with the goal of identifying modifiable factors in the peri-operative period with a particular focus on blood glucose levels. Independent associations with worse post-operative function included: patient age, pre-operative motor deficit, deep tumor location, post-operative motor deficit, and elevated mean peri-operative glucose. Interestingly, controlling for associated factors including dexamethasone dosing, patients with elevated peri-operative glucose levels were nearly twice as likely to have new post-operative neurological deficits. These results suggest, together with the broad literature supporting a role for hyperglycemia in neurological injury, that this may represent a modifiable factor in the peri-operative care of these patients.
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2011.09.031