Fu Jack B, Gupta Ekta, Morishita Shinichiro, Andersen Clark R, Ngo-Huang An T, Engle Jessica P, Guo Ying
Department of Palliative, Rehabilitation and Integrative Medicine, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1414, Houston, TX, 77030, USA.
Department of Physical Therapy, Fukushima Medical University, Fukushima, Japan.
Support Care Cancer. 2023 Jan 19;31(2):122. doi: 10.1007/s00520-023-07591-z.
To determine the percentage of and factors associated with unplanned transfer to the acute care service of glioblastoma multiforme acute rehabilitation inpatients.
Retrospective review of glioblastoma multiforme acute rehabilitation inpatients admitted 4/1/2016-3/31/2020 at a National Cancer Institute Comprehensive Cancer Center.
One hundred thirty-nine consecutive admissions of unique glioblastoma multiforme acute rehabilitation inpatients were analyzed. Fifteen patients (10.7%, 95% confidence interval 6.5-17.1%) were transferred to the acute care service for unplanned reasons. The most common reasons for transfer back were neurosurgical complication 6/15(40%), neurologic decline due to mass effect 4/15(26.7%), and pulmonary embolism 2/15(13.3%). Older age (p = 0.010), infection prior to acute inpatient rehabilitation transfer (p = 0.020), and lower activity measure of post-acute care 6-click basic mobility scores (p = 0.048) were significantly associated with transfer to the acute care service. Patients who transferred to the acute care service had significantly lower overall survival than patients who did not transfer off (log-rank test p = 0.001).
Acute inpatient physiatrists should closely monitor patients for neurosurgical and neurologic complications. The variables significantly associated with transfer to the acute care service may help identify patients at increased risk for medical complications who may require closer observation.
确定多形性胶质母细胞瘤急性康复住院患者非计划转入急性护理服务的比例及相关因素。
回顾性分析2016年4月1日至2020年3月31日在一家国立癌症研究所综合癌症中心收治的多形性胶质母细胞瘤急性康复住院患者。
对139例连续入院的多形性胶质母细胞瘤急性康复住院患者进行了分析。15例患者（10.7%，95%置信区间6.5 - 17.1%）因非计划原因转入急性护理服务。转回的最常见原因是神经外科并发症6/15（40%）、因占位效应导致的神经功能衰退4/15（26.7%）和肺栓塞2/15（13.3%）。年龄较大（p = 0.010）、急性住院康复转院之前存在感染（p = 0.020）以及急性后期护理6点基本活动能力评分的活动量较低（p = 0.048）与转入急性护理服务显著相关。转入急性护理服务的患者总体生存率显著低于未转出的患者（对数秩检验p = 0.001）。
急性住院物理治疗师应密切监测患者是否出现神经外科和神经系统并发症。与转入急性护理服务显著相关的变量可能有助于识别医疗并发症风险增加、可能需要密切观察的患者。
