Chintapalli Renuka
School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge, United Kingdom.
Asian J Neurosurg. 2024 Jun 10;19(3):412-418. doi: 10.1055/s-0044-1787674. eCollection 2024 Sep.
Patient-reported outcome measures (PROMs) have gained traction in assessing patients' health around surgery. Among these, the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29) is a widely accepted tool for evaluating overall health, yet its applicability in cranial neurosurgery remains uncertain. This study aimed to evaluate the predictive value of preoperative PROMIS-29 scores for postoperative outcomes in patients undergoing brain tumor resection. We identified adult patients undergoing brain tumor resection at a single neurosurgical center between January 2018 and December 2021. We analyzed physical health (PH) summary scores to determine optimal thresholds for predicting length of stay (LOS), discharge disposition (DD), and 30-day readmission. Bivariate analyses were conducted to examine the distribution of PH scores based on patient characteristics. Multivariate logistic regression models were employed to assess the association between preoperative PH scores and short-term postoperative outcomes. Among 157 patients (mean age 55.4 years, 58.0% female), 14.6% exhibited low PH summary scores. Additionally, 5.7% experienced prolonged LOS, 37.6% had nonroutine DDs, and 19.1% were readmitted within 30 days. Bivariate analyses indicated that patients with low PH summary scores, indicating poorer baseline PH, were more likely to have malignant tumors, nonelective admissions, and adverse outcomes. In multivariate analysis, low PH summary scores independently predicted increased odds of prolonged LOS (odds ratio [OR] = 6.09, = 0.003), nonroutine DD (OR = 4.25, = 0.020), and 30-day readmission (OR = 3.93, = 0.020). The PROMIS-29 PH summary score serves as a valuable predictor of short-term postoperative outcomes in brain tumor patients. Integrating this score into clinical practice can enhance the ability to anticipate meaningful postoperative results.
患者报告结局测量指标（PROMs）在评估手术前后患者健康状况方面越来越受到关注。其中，29项患者报告结局测量信息系统（PROMIS - 29）是评估整体健康状况的一种广泛接受的工具，但其在颅脑神经外科手术中的适用性仍不确定。 本研究旨在评估术前PROMIS - 29评分对脑肿瘤切除患者术后结局的预测价值。 我们确定了2018年1月至2021年12月期间在单一神经外科中心接受脑肿瘤切除的成年患者。我们分析了身体健康（PH）总结评分，以确定预测住院时间（LOS）、出院处置（DD）和30天再入院的最佳阈值。进行双变量分析以检查基于患者特征的PH评分分布。采用多变量逻辑回归模型评估术前PH评分与术后短期结局之间的关联。 在157例患者（平均年龄55.4岁，58.0%为女性）中，14.6%的患者PH总结评分较低。此外，5.7%的患者住院时间延长，37.6%的患者出院处置非常规，19.1%的患者在30天内再次入院。双变量分析表明，PH总结评分较低（表明基线PH较差）的患者更有可能患有恶性肿瘤、非择期入院和出现不良结局。在多变量分析中，低PH总结评分独立预测住院时间延长的几率增加（优势比[OR] = 6.09， = 0.003）、非常规出院处置（OR = 4.25， = 0.020）和30天再入院（OR = 3.93， = 0.020）。 PROMIS - 29 PH总结评分是脑肿瘤患者术后短期结局的有价值预测指标。将该评分纳入临床实践可提高预测有意义术后结果的能力。
