Effects of Chronic Steroid Therapy in Patients with Metabolic Syndrome Undergoing Anterior Skull Base Surgery

Objective: The purpose of this study is to investigate if there is a significant association between chronic steroid therapy use in patients with metabolic syndrome and perioperative complication rates following anterior skull base surgery.

Study Design: This is a retrospective database review.

Methods: The 2005 to 2015 National Surgical Quality Improvement Program (NSQIP) database was used. Chi-squared analysis, independent samples t-tests, and logistic regression were used to determine statistical association between patient cohorts and perioperative complication events.

Results: A total of 4,053 patients who underwent anterior skull base surgery were identified using the NSQIP database. Patients who met inclusion criteria for metabolic syndrome included those with three comorbid conditions, specifically diabetes mellitus, BMI ≥ 30 kg/m², and hypertension medication usage. Patients with these three comorbid conditions were classified as having metabolic syndrome. A cohort of 286 patients who underwent anterior skull base surgery fit this inclusion criteria. Univariate analysis, as well as logistic regression, showed that patients undergoing anterior skull base surgery with metabolic syndrome were more likely to have chronic steroid usage (p = 0.011). Further analysis demonstrates significant association between comorbid steroid use and postoperative pneumonia (p = 0.021) and reintubation (p = 0.021) in this patient cohort. Independent samples t-test showed that comorbid steroid use is associated with increased total length of hospital stay (p = 0.001) following surgery.

Conclusion: Patients undergoing anterior skull base surgery who fit inclusion criteria for metabolic syndrome were significantly associated with chronic steroid use. Further analysis revealed a statistical tie between the comorbid steroid use of this cohort and the prevalence of pneumonia and reintubation complications that were observed in the overall cohort.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
12 February 2021