脑肿瘤切除术患者与身体健康相关的生活质量和手术后疗效

Renuka Chintapalli
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摘要

摘要 背景 患者报告结果测量法(PROMs)在评估手术前后患者健康状况方面得到了广泛应用。其中,由29个项目组成的患者报告结果测量信息系统(PROMIS-29)是一种广为接受的评估总体健康状况的工具,但其在颅神经外科手术中的适用性仍不确定。目的 本研究旨在评估脑肿瘤切除术患者术前 PROMIS-29 评分对术后结果的预测价值。方法 我们确定了 2018 年 1 月至 2021 年 12 月期间在一家神经外科中心接受脑肿瘤切除术的成年患者。我们分析了身体健康(PH)汇总得分,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。我们进行了双变量分析,以检查基于患者特征的 PH 评分分布情况。采用多变量逻辑回归模型评估术前 PH 评分与术后短期预后之间的关系。结果 157 名患者(平均年龄 55.4 岁,58.0% 为女性)中,14.6% 的患者 PH 总分较低。此外,5.7%的患者延长了住院时间,37.6%的患者出现了非程序性DD,19.1%的患者在30天内再次入院。双变量分析表明,PH 总分低的患者表明其 PH 基线较差,更有可能患有恶性肿瘤、非选择性入院和不良预后。在多变量分析中,低 PH 总分可独立预测延长 LOS(几率比 [OR] = 6.09,P = 0.003)、非例行 DD(OR = 4.25,P = 0.020)和 30 天再入院(OR = 3.93,P = 0.020)的几率增加。结论 PROMIS-29 PH 综合评分是预测脑肿瘤患者术后短期预后的重要指标。将该评分纳入临床实践可提高预测有意义的术后结果的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Physical Health-Related Quality of Life and Postsurgical Outcomes in Brain Tumor Resection Patients
Abstract Background  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. Objective  This study aimed to evaluate the predictive value of preoperative PROMIS-29 scores for postoperative outcomes in patients undergoing brain tumor resection. Methods  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. Results  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, p  = 0.003), nonroutine DD (OR = 4.25, p  = 0.020), and 30-day readmission (OR = 3.93, p  = 0.020). Conclusion  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.
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