title: Absence of an association between glucose levels and surgical site infections in patients undergoing craniotomies for brain tumors.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Brain Tumor & Neuro-Oncology Center, Department of Neurosurgery, the Neurological Institute, Cleveland, Ohio, USA. hardys2@ccf.org
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Hardy
authors.forename: Amy S
authors.initials: AS
authors.lastname: Nowacki
authors.forename: Mary
authors.initials: M
authors.lastname: Bertin
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Weil
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001786:Blood Glucose; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D016022:Case-Control Studies; D003399:Craniotomy / Q000706:statistics & numerical data*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology*; D016015:Logistic Models; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D001786:Blood Glucose