Hormones · Melatonin

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).

1 min readUpdated Aug 15, 20260 RCTsView structured evidence →
Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★
Confidencelow

This article is automatically generated from the structured evidence profile behind the claim above. Scores reflect the quality and quantity of available research, not clinical advice.

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

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. 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
Disclaimer: This article is auto-generated from structured research data for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.