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初诊后入住住院康复病房与胶质母细胞瘤复发性患者的功能结局比较。

A Comparison of Functional Outcomes between Patients Admitted to Inpatient Rehabilitation after Initial Diagnosis Versus Recurrence of Glioblastoma Multiforme.

机构信息

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.

Spaulding Rehabilitation Hospital, Charlestown, MA, USA.

出版信息

PM R. 2020 Oct;12(10):975-983. doi: 10.1002/pmrj.12379. Epub 2020 May 12.

Abstract

BACKGROUND

Prior studies of inpatient rehabilitation of patients with brain tumor demonstrate similar functional gains as compared to other rehabilitation populations. There are few studies specifically examining the rehabilitation of patients with glioblastoma.

OBJECTIVE

To compare functional outcomes between matched patients admitted to acute inpatient rehabilitation after initial diagnosis of glioblastoma (iGBM) and after diagnosis of recurrent glioblastoma (rGBM).

DESIGN

A retrospective, case-matched study using descriptive statistics compared demographic information and functional outcomes as designated by the Functional Independence Measure (FIM) score.

SETTING

A single, freestanding inpatient rehabilitation hospital.

PATIENTS

Over a 20-month period, 25 patients with iGBM were matched with 25 patients admitted to an inpatient rehabilitation facility with rGBM by the following criteria: (1) side of lesion (left/right hemisphere), (2) admission total FIM score within 10 points, (3) age within 10 years, and (4) gender. Nineteen of the 25 patients in each group were matched meeting all criteria, and 6 of the 25 patients were matched meeting three out of four criteria.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

The primary outcome measures were differences in functional outcomes as measured by FIM scores.

RESULTS

There were no statistically significant differences (P < .05) between the groups in mean admission FIM scores, discharge FIM scores, FIM gains, and FIM efficiencies. There were no statistically significant differences in the development of complications during acute rehabilitation and transfer rate to acute care hospital. Sixty-four percent of patients in both groups were able to be discharged home.

CONCLUSIONS

This study demonstrated no statistically significant differences in functional outcomes between matched patients admitted with iGBM compared to rGBM. Further studies are indicated to examine the rehabilitation outcomes of patients with rGBM in inpatient rehabilitation.

摘要

背景

先前对脑肿瘤患者住院康复的研究表明,与其他康复人群相比,他们的功能增益相似。专门研究胶质母细胞瘤患者康复的研究很少。

目的

比较初诊为胶质母细胞瘤(iGBM)和复发性胶质母细胞瘤(rGBM)患者接受急性住院康复治疗后的功能结局。

设计

采用描述性统计的回顾性病例匹配研究,比较功能独立性测量(FIM)评分指定的人口统计学信息和功能结局。

设置

一家独立的住院康复医院。

患者

在 20 个月的时间里,25 名 iGBM 患者与 25 名因 rGBM 入院的患者通过以下标准进行匹配:(1)病变侧(左/右半球),(2)入院时 FIM 总分相差 10 分,(3)年龄相差 10 岁,(4)性别相同。每组中有 19 名患者符合所有标准,有 6 名患者符合四项标准中的三项。

干预措施

不适用。

主要观察指标

主要观察指标是 FIM 评分测量的功能结局差异。

结果

两组患者的入院 FIM 评分、出院 FIM 评分、FIM 增益和 FIM 效率的平均值均无统计学差异(P<0.05)。在急性康复期间发生并发症的发展和转至急性护理医院的比率方面无统计学差异。两组中各有 64%的患者能够出院回家。

结论

本研究表明,与 rGBM 相比,初诊为 iGBM 的患者在功能结局方面无统计学差异。需要进一步研究以检查 rGBM 患者在住院康复中的康复结果。

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