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原发性脑肿瘤患者康复期间非计划性急性护理单元再入院的发生率及相关因素:一项回顾性研究

INCIDENCE AND ASSOCIATIONS OF UNPLANNED ACUTE CARE UNIT READMISSIONS OF PRIMARY BRAIN TUMOUR PATIENTS DURING REHABILITATION: A RETROSPECTIVE STUDY.

作者信息

Tay Matthew Rong Jie, Seah Justin Desheng, Chua Karen Sui Geok

机构信息

Tan Tock Seng Hospital Rehabilitation Centre, Singapore.

Institute of Rehabilitation Excellence (IREx), Singapore.

出版信息

J Rehabil Med Clin Commun. 2025 Apr 1;8:41974. doi: 10.2340/jrm-cc.v8.41974. eCollection 2025.

Abstract

OBJECTIVE

To examine incidence and associations for unplanned Acute Care Unit Readmissions (ACURs) in Asian primary brain tumour patients.

DESIGN

A retrospective single-centre cohort study.

PATIENTS

A total of 173 Asian primary brain tumour patients undergoing inpatient rehabilitation in a tertiary rehabilitation centre.

METHODS

Primary outcome was unplanned ACUR. Logistic regression analysis was used to determine associations with patients who had an unplanned ACUR.

RESULTS

Altogether, the majority of patients had low-grade (World Health Organization Class I and II) tumours (76.9%), whilst 32 (18.5%) patients had glioblastoma multiforme tumours. Unplanned ACUR occurred in 27 (15.9%) patients, with the 2 most common causes being neurosurgical complications (37.0%) and non-neurosurgical infections (25.9%). Significant risk factors for ACUR patients were a longer acute hospitalization stay (odds ratio = 1.024; 95% confidence interval [CI] = 1.01-1.04; = 0.007), whereas a higher admission motor Functional Independence Measure was protective against unplanned ACUR (odds ratio = 0.945; 95% CI = 0.915-0.977; = 0.001).

CONCLUSIONS

Despite rehabilitation goals of prevention of complications, patients with primary brain tumours undergoing inpatient rehabilitation continue to demonstrate significant unplanned ACUR rates (15.9%) with neurosurgical complications being common. These findings underscore the importance of continued vigilance, access to and coordination of neurosurgical care and management beyond the acute surgical phase, in order to ensure optimal outcomes.

摘要

目的

研究亚洲原发性脑肿瘤患者非计划性急性护理单元再入院(ACURs)的发生率及相关因素。

设计

一项回顾性单中心队列研究。

患者

共有173例亚洲原发性脑肿瘤患者在一家三级康复中心接受住院康复治疗。

方法

主要结局为非计划性ACUR。采用逻辑回归分析确定与发生非计划性ACUR的患者相关的因素。

结果

总体而言,大多数患者患有低级别(世界卫生组织I级和II级)肿瘤(76.9%),而32例(18.5%)患者患有多形性胶质母细胞瘤。27例(15.9%)患者发生了非计划性ACUR,最常见的两个原因是神经外科并发症(37.0%)和非神经外科感染(25.9%)。ACUR患者的显著危险因素是急性住院时间较长(比值比=1.024;95%置信区间[CI]=1.01-1.04;P=0.007),而较高的入院运动功能独立性测量值可预防非计划性ACUR(比值比=0.945;95%CI=0.915-0.977;P=0.001)。

结论

尽管康复目标是预防并发症,但接受住院康复治疗的原发性脑肿瘤患者仍有较高的非计划性ACUR发生率(15.9%),神经外科并发症很常见。这些发现强调了在急性手术阶段之后持续保持警惕、获得并协调神经外科护理和管理的重要性,以确保最佳治疗效果。

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