Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A.
Division of Neurosurgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A.
Laryngoscope. 2021 Mar;131(3):644-648. doi: 10.1002/lary.28910. Epub 2020 Aug 5.
To examine whether simple mobility assessments can predict functional limitations and length of hospitalization after acoustic neuroma (AN) resection.
Prospective case series.
A prospective clinical study of adult patients undergoing AN resection by either the translabyrinthine, retrosigmoid, or middle fossa approach was conducted at a tertiary center. Preoperative mobility assessments included the functional gait assessment (FGA) and the 10-m walk (10 MW). Postoperatively, the Activity Measure for Post-Acute Care (AMPAC, at 48 hours), FGA, and 10 MW (at 1 week) were obtained. Demographic and medical data were collected.
One hundred and thirty-eight patients were analyzed (mean age: 48.3 years, 68.8% female). Mean length of stay (LOS) was 3.1 days. The translabyrinthine approach was most commonly performed (48.6%). On regression analyses, preoperative FGA (P = 0.03) and 48-hour postoperative AM-PAC (P < 0.001) independently predicted LOS, even after accounting for age, gender, body mass index, and tumor size. On receiver operating characteristic analysis, a preoperative FGA cut score of 25.5 predicted a protracted hospital stay (>4 days) with a sensitivity of 77% and specificity of 50% (area under curve: 68.5).
This study demonstrated that preoperative mobility assessments can predict functional limitations and LOS after AN resection. These objective tools can be used by clinicians to manage expectations and guide preoperative counseling in patients considering surgery.
3 Laryngoscope, 131:644-648, 2021.
研究在听神经瘤（AN）切除术后，简单的移动能力评估是否可以预测功能限制和住院时间。
前瞻性病例系列研究。
在一家三级中心对接受经迷路、乙状窦后或中颅窝入路切除 AN 的成年患者进行了前瞻性临床研究。术前移动能力评估包括功能性步态评估（FGA）和 10 米步行（10MW）。术后 48 小时获得活动后急性护理测量（AMPAC，在 48 小时）、FGA 和 10MW（在 1 周）。收集人口统计学和医疗数据。
共分析了 138 例患者（平均年龄：48.3 岁，68.8%为女性）。平均住院时间（LOS）为 3.1 天。最常采用经迷路入路（48.6%）。在回归分析中，术前 FGA（P = 0.03）和术后 48 小时 AMPAC（P < 0.001）独立预测 LOS，即使考虑到年龄、性别、体重指数和肿瘤大小。在受试者工作特征分析中，术前 FGA 得分 25.5 预测住院时间延长（>4 天），其灵敏度为 77%，特异性为 50%（曲线下面积：68.5%）。
本研究表明，术前移动能力评估可预测 AN 切除术后的功能限制和 LOS。这些客观工具可用于临床医生管理患者的预期并指导术前咨询。
3 级喉镜，131：644-648，2021 年。
