1Department of Surgical Nursing, Faculty of Nursing, Necmettin Erbakan University, Konya, Turkey
2Department of Surgical Nursing, Faculty of Nursing, Mersin University, Mersin, Turkey
3Department of Brain and Nerve Surgery, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
4Department of General Intensive Care, Ministry of Health Balıkesir Provincial Health Directorate Atatürk City Hospital , Balıkesir, Turkey
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.
Keywords: Critical patient; glycemic control; neurosurgical patient; stress hyperglycemia