Fink Larissa, von Saß Christiane, Golla Heidrun, Voltz Raymond, Muehlensiepen Felix, Ploner Christoph J, Slotty Philipp J, van Oorschot Birgitt, Kowski Alexander B, Kamp Marcel A
Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Am Seebad 82/83, 15562, Rüdersdorf bei Berlin, Germany.
Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
J Neurooncol. 2025 May;173(1):37-48. doi: 10.1007/s11060-024-04928-4. Epub 2025 Apr 11.
Cerebral metastases (CM) are the most common intracranial neoplasms, significantly impacting patient quality-of-life. Despite advancements in diagnostics and therapeutics, the burden remains high. This study evaluates inpatient management, palliative care use, and mortality outcomes for CM patients in German hospitals in 2022.
A cross-sectional analysis was conducted on 71,787 inpatient cases involving adult CM and leptomeningeal malignancies patients in German hospitals in 2022. Data submitted by hospitals according to §21 of the Hospital Remuneration Act were analyzed, focusing on demographic data, primary tumor types, treatment methods, participation in palliative care, and discharge outcomes.
Among the 71,787 cases, 53.4% were patients aged 65 years or older. Malignant lung tumors were present in 61.6% of cases, followed by breast malignancies (12%) and malignant melanoma and diffuse diffuse large B-cell lymphoma (each 6.4%). Specialized inpatient palliative care (SIPC) was provided in 14.8% (10,636 cases), with 85.2% not receiving such care. Hospital mortality was 13.1% (9413 cases), with 42.2% of these involving patients who received SIPC. Discharge outcomes included discharge home (72.7%), transfers to other hospitals (7.1%), rehabilitation facilities (0.4%), nursing facilities (2%), and hospices (2.4%).
Despite treatment advances, high mortality rates for CM patients persist, underscoring the need for palliative care integration and comprehensive training to enhance patient outcomes. Health care planning is a growing topic, our study establishes a benchmark for CM care in German hospitals, revealing a significant number of patients not receiving SIPC. This research can inform future healthcare strategies in neuro-oncology.
脑转移瘤（CM）是最常见的颅内肿瘤，对患者生活质量有重大影响。尽管诊断和治疗方面取得了进展，但负担仍然很重。本研究评估了2022年德国医院中CM患者的住院管理、姑息治疗使用情况和死亡率结果。
对2022年德国医院中涉及成人CM和软脑膜恶性肿瘤患者的71787例住院病例进行了横断面分析。分析了医院根据《医院薪酬法》第21条提交的数据，重点关注人口统计学数据、原发肿瘤类型、治疗方法、参与姑息治疗情况和出院结果。
在71787例病例中，53.4%为65岁及以上患者。61.6%的病例存在恶性肺肿瘤，其次是乳腺恶性肿瘤（12%）、恶性黑色素瘤和弥漫性大B细胞淋巴瘤（各占6.4%）。14.8%（10636例）的患者接受了专门的住院姑息治疗（SIPC），85.2%的患者未接受此类治疗。医院死亡率为13.1%（9413例），其中42.2%涉及接受SIPC的患者。出院结果包括回家（72.7%）、转至其他医院（7.1%）、康复机构（0.4%）、护理机构（2%）和临终关怀机构（2.4%）。
尽管治疗取得了进展，但CM患者的高死亡率仍然存在，这突出了整合姑息治疗和进行全面培训以改善患者结局的必要性。医疗保健规划是一个日益重要的话题，我们的研究为德国医院的CM护理建立了一个基准，揭示了大量患者未接受SIPC。这项研究可为未来神经肿瘤学中的医疗保健策略提供参考。
