Prevalence, Predictors, and Outcomes of Steroid-induced Hyperglycemia in Brain Tumor Patients in the Perioperative Setting

Introduction: Corticosteroid therapy plays a critical role in managing cerebral edema and neurological deficits in patients with brain tumors, particularly in the neuro-oncology perioperative setting. However, steroid use can precipitate hyperglycemia, impacting patient outcomes. This study investigates the prevalence, predictors, and consequences of steroid-induced hyperglycemia (SIH) in glioblastoma patients undergoing craniotomy or laser interstitial thermal therapy (LITT).

Methods: This prospective study will include glioblastoma patients hospitalized on a neurosurgical service and undergoing craniotomy or laser interstitial thermal therapy (LITT) for tumor excision. Inclusion criteria encompass perioperative administration of dexamethasone administration and documented fasting plasma glucose (FPG) or HbA1c measurements pre-surgery, during hospitalization, and up to six months postoperatively. Hyperglycemia will be defined as any glucose level exceeding 179mg/dL within the first four days post-surgery. Associations between variables will be analyzed using Spearman's correlations and multivariable linear regression.

Results: The analysis will report the total number of patients who meet the inclusion criteria, along with average age, mean postoperative blood glucose levels, and SIH incidence. Additional data will include patterns of antidiabetic therapy, predictors of hospital length of stay, mean steroid dosage, and adverse outcomes associated with hyperglycemia.

Conclusion : This study aims to highlight the prevalence of SIH in the neuro-oncology perioperative setting and its potential impact on patient outcomes. Findings will provide insights into the management of SIH and its associated risks in this vulnerable patient population.