Perioperative circadian rhythm disruption is associated with adverse outcomes following skull base surgery
This prospective cohort study of 82 patients undergoing skull base tumor resection found significant perioperative disruption of circadian rhythms, marked by suppressed melatonin and elevated cortisol, which was associated with higher complication rates and longer hospital stays. Patients with the highest circadian disruption had significantly more overall complications (73.9% vs. 39.0%, p=0.042) and longer hospital stay (8.0 vs. 7.9 days, p=0.018).
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Perioperative circadian rhythm disruption is associated with adverse outcomes following skull base surgery The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 32/100 (low).
The Claim
Perioperative circadian rhythm disruption is associated with adverse outcomes following skull base surgery
This conclusion is most relevant to: Adults undergoing elective skull base tumor resection.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Impact of Perioperative Circadian Rhythm Disruption on Recovery and Complications in Skull Base Surgery: A Prospective Cohort Study. (Asian journal of neurosurgery, 2026) —
How It Works
The proposed biological pathway:
- ▸Surgical stress causes suppression of melatonin and elevation of cortisol
- ▸Disruption of circadian rhythms leads to poorer sleep quality
- ▸Impaired recovery and increased susceptibility to complications
- ▸Result: Higher complication rates and longer hospital stay
Who Might Benefit
Evidence fit by population:
- ▸Adults undergoing elective skull base tumor resection
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Observational design cannot establish causality
- ▸Single-center study may limit generalizability
- ▸Potential confounding factors not fully controlled
Frequently Asked Questions
What is the main finding of this study?▼
Perioperative circadian disruption, measured by melatonin and cortisol changes, is common and associated with worse outcomes after skull base surgery.
How was circadian disruption measured?▼
Serum melatonin and cortisol were measured preoperatively and on postoperative days 1, 3, and 7, along with sleep quality using the Pittsburgh Sleep Quality Index.
What were the complication rates?▼
Overall, 48.8% had postoperative complications, with CSF leak (23.2%), infection (14.6%), and neurological deficits (11.0%).
Could preserving circadian rhythm improve outcomes?▼
The authors suggest that strategies to preserve circadian alignment perioperatively could improve recovery and reduce complications, but this needs further testing.
References
- 1.Gupta K, Singh S, Gupta K. “Impact of Perioperative Circadian Rhythm Disruption on Recovery and Complications in Skull Base Surgery: A Prospective Cohort Study..” Asian journal of neurosurgery, 2026. PMID: 42535145 DOI: 10.1055/s-0046-1819645