Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA.
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
J Clin Neurosci. 2024 Sep;127:110746. doi: 10.1016/j.jocn.2024.07.007. Epub 2024 Jul 29.
Glioblastoma patients may develop functional deficits post-operatively that affect activities of daily living and result in worse outcomes. The Activity Measure for Post-Acute Care (AM-PAC) instrument assigns patients basic mobility and daily activity scores, but it is unknown if these scores correlate with post-operative outcomes in glioblastoma patients.
Adult (≥18 years) glioblastoma patients evaluated by physical/occupational therapy after resection at a single instution (June 2008-December 2020) were identified. Patient demographics, post-operative AM-PAC scores, and clinical outcomes were collected. Multivariate regression identified associations between AM-PAC scores and post-operative outcomes.
600 patients were included (mean age 59.3 years, 59.2 % male); 151 (25.3 %) and 246 (43.8 %) patients had low mobility (<42.9) and activity (<39.4) scores, respectively. 103 (17.2 %) and 177 (29.5 %) patients experienced extended lengths of stay (LOS) in the ICU (≥2 days) and overall (≥7 days), respectively. 154 (25.7 %) patients had non-home discharges. The 30-day readmission rate was 13.7 %. In multivariate analysis, low mobility scores correlated with increased odds of extended overall (p < 0.0001) and ICU (p = 0.0004) LOS, non-home discharge (p < 0.0001), and 30-day readmission (p = 0.0405). Low activity scores correlated with extended overall LOS (<0.0001) and non-home discharge (p < 0.0001). In log-rank analysis, median survival time was shorter for patients with low mobility (9.5 vs. 14.7 months, p < 0.0001) and activity (10.6 vs. 16.3 months, p < 0.0001) scores than for high-scoring patients.
AM-PAC basic mobility and daily activity scores are associated with outcomes after glioblastoma resection. These easily obtainable scores may be useful for prognosticating and guiding decision making in post-operative glioblastoma patients.
胶质母细胞瘤患者术后可能会出现影响日常生活活动的功能障碍，导致预后更差。活动后康复护理评估量表（AM-PAC）为患者分配基本的移动能力和日常活动评分，但尚不清楚这些评分是否与胶质母细胞瘤患者的术后结果相关。
本研究纳入了在单一机构（2008 年 6 月至 2020 年 12 月）接受手术切除后接受物理/职业治疗评估的成年（≥18 岁）胶质母细胞瘤患者。收集了患者的人口统计学、术后 AM-PAC 评分和临床结果。多变量回归分析确定了 AM-PAC 评分与术后结果之间的关联。
共纳入 600 例患者（平均年龄 59.3 岁，59.2%为男性）；151 例（25.3%）和 246 例（43.8%）患者的移动能力评分（＜42.9）和活动能力评分（＜39.4）较低。103 例（17.2%）和 177 例（29.5%）患者的 ICU 住院时间（≥2 天）和总住院时间（≥7 天）延长。154 例（25.7%）患者非居家出院。30 天再入院率为 13.7%。多变量分析显示，移动能力评分较低与总住院时间（p＜0.0001）和 ICU 住院时间（p=0.0004）延长、非居家出院（p＜0.0001）和 30 天再入院（p=0.0405）的可能性增加相关。活动能力评分较低与总住院时间（p＜0.0001）和非居家出院（p＜0.0001）延长相关。在对数秩分析中，移动能力评分较低（9.5 个月 vs. 14.7 个月，p＜0.0001）和活动能力评分较低（10.6 个月 vs. 16.3 个月，p＜0.0001）的患者的中位生存时间短于评分较高的患者。
AM-PAC 基本移动能力和日常活动评分与胶质母细胞瘤切除术后的结果相关。这些易于获得的评分可能有助于预测和指导胶质母细胞瘤患者术后的决策。
