Fischl Anna, Gerken Michael, Roos Philipp, Haedenkamp Tareq, Hillberg Andrea, Klinkhammer-Schalke Monika, Kölbl Oliver, Linker Ralf, Proescholdt Martin, Pukrop Tobias, Riemenschneider Markus J, Schmidt Nils Ole, Schön Ingrid, Vogelhuber Martin, Hau Peter, Bumes Elisabeth
Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany.
Center for Quality Assurance and Health Services Research, University of Regensburg, Regensburg, Germany.
Neurooncol Pract. 2023 Apr 27;10(5):446-453. doi: 10.1093/nop/npad023. eCollection 2023 Oct.
Malignant isocitrate dehydrogenase wild-type (IDHwt) gliomas impose a high symptomatic and psychological burden. Wide distances from patients' homes to cancer centers may affect the delivery of psycho-oncological care. Here, we investigated, in a large brain tumor center with a rural outreach, the initiation of psycho-oncological care depending on spatial distance and impact of psycho-oncological care on emergency visits.
Electronic patient charts, the regional tumor registry, and interviews with the primary care physicians were used to investigate clinical data, psycho-oncological care, and emergency unit visits. Interrelations with socio-demographic, clinical, and treatment aspects were investigated using univariable and multivariable binary logistic regression analysis and the Pearson's Chi-square test.
Of 491, 229 adult patients of this retrospective cohort fulfilled the inclusion criteria for analysis. During the last three months of their lives, 48.9% received at least one psycho-oncological consultation, and 37.1% visited the emergency unit at least once. The distance from the cancer center did neither affect the initiation of psycho-oncological care nor the rate of emergency unit visits. Receiving psycho-oncological care did not correlate with the frequency of emergency unit visits in the last three months of life.
We conclude that the distance of IDHwt glioma patients' homes from their cancer center, even in a rural area, does not significantly influence the rate of psycho-oncological care.
恶性异柠檬酸脱氢酶野生型（IDHwt）胶质瘤给患者带来了沉重的症状负担和心理负担。患者住所与癌症中心距离较远可能会影响心理肿瘤护理的提供。在此，我们在一个设有农村外展服务的大型脑肿瘤中心，研究了心理肿瘤护理的启动情况与空间距离的关系，以及心理肿瘤护理对急诊就诊的影响。
使用电子病历、区域肿瘤登记处的数据以及对初级保健医生的访谈来调查临床数据、心理肿瘤护理情况和急诊就诊情况。使用单变量和多变量二元逻辑回归分析以及Pearson卡方检验来研究与社会人口统计学、临床和治疗方面的相互关系。
在这个回顾性队列的491名成年患者中，229名符合分析的纳入标准。在他们生命的最后三个月里，48.9%的患者至少接受了一次心理肿瘤咨询，37.1%的患者至少去过急诊室一次。与癌症中心的距离既不影响心理肿瘤护理的启动，也不影响急诊就诊率。接受心理肿瘤护理与生命最后三个月的急诊就诊频率无关。
我们得出结论，即使在农村地区，IDHwt胶质瘤患者住所与癌症中心的距离也不会显著影响心理肿瘤护理的比例。
