Department of Neurosurgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.
Department of Science Administration, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.
Neurosurg Rev. 2024 Sep 7;47(1):565. doi: 10.1007/s10143-024-02804-3.
Craniotomy to remove brain tumors is an intricate procedure with multiple postoperative symptoms. However, there has been limited research on the symptom networks of these patients. To this end, this study aims to explore these symptom networks, revealing their interplay to inform better symptom control, hasten the discovery of postoperative issues, and tailor Enhanced Recovery After Surgery (ERAS) protocols, all to enhance recovery and enhance patient care.
From September 2023 to March 2024, 211 patients with primary brain tumors who underwent craniotomy at Shanghai Tongji Hospital were recruited. Their symptoms were assessed using the MDASI-BT (M.D. Anderson Symptom Inventory Brain Tumor Module) one day post-craniotomy. The symptom network of 22 symptoms was visualized using R, with central and bridge symptoms identified.
Sadness (r=2.482) and difficulty in understanding (r=1.138) have the highest strength of all symptoms, indicating they are the central symptoms. Sadness (r=2.155) and loss of appetite (r=1.828) have the highest value of betweenness, indicating they are the bridge symptoms. Strong correlations were found between difficulty in understanding and difficulty in speaking (r = 0.701), distress and sadness (r = 0.666), fatigue and lethargy (r = 0.632), and nausea and vomiting (r = 0.601). Subgroup analysis revealed that noninvasive tumor patients exhibited similar symptom networks to the overall cohort, whereas invasive tumor patients showed weak symptom connections, resulting in no discernible network.
This study underscores the importance of understanding symptom networks in brain tumor patients post-craniotomy, highlighting key symptom interrelationships. These insights can guide more effective symptom management, early complication detection, and optimization of ERAS protocols, ultimately enhancing recovery and patient care.
开颅切除脑瘤是一项复杂的手术，术后会出现多种症状。然而，针对这些患者的症状网络，相关研究十分有限。为此，本研究旨在探索这些症状网络，揭示它们之间的相互作用，以便更好地控制症状，尽早发现术后问题，并制定增强术后恢复（ERAS）方案，从而促进患者康复，改善患者护理。
本研究于 2023 年 9 月至 2024 年 3 月，招募了 211 名在上海同济大学医院接受开颅手术的原发性脑肿瘤患者。术后一天，采用 MDASI-BT（安德森症状评估量表-脑肿瘤模块）评估他们的症状。使用 R 可视化 22 个症状的症状网络，确定中心症状和桥梁症状。
所有症状中，悲伤（r=2.482）和理解困难（r=1.138）的相关性最强，表明它们是中心症状。悲伤（r=2.155）和食欲不振（r=1.828）的中介作用最高，表明它们是桥梁症状。理解困难与言语困难（r = 0.701）、痛苦与悲伤（r = 0.666）、疲劳与昏睡（r = 0.632）、恶心与呕吐（r = 0.601）之间存在较强的相关性。亚组分析显示，非侵袭性肿瘤患者与总体队列表现出相似的症状网络，而侵袭性肿瘤患者的症状连接较弱，导致无法形成明显的网络。
本研究强调了理解开颅术后脑瘤患者症状网络的重要性，突出了关键症状之间的相互关系。这些发现可以指导更有效的症状管理、早期并发症检测和 ERAS 方案的优化，从而促进患者康复和改善患者护理。
