神经胶质瘤切除术患者永久性和暂时性运动障碍的预测因素：系统回顾和荟萃分析。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-06-25 DOI:10.1016/j.wneu.2025.124200

Brian J. Conway , Stephanie A. Armstrong , Nada Botros , Sergey Tarima , Max O. Krucoff

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引用次数: 0

摘要

目的：确定脑胶质瘤切除术患者永久性和暂时性运动障碍的预测因素。方法：通过文献检索Ovid Medline、Scopus、Web of Science、CINAHL/EBSCO、PsychInfo、Cochrane和Wiley等数据库，检索报道神经胶质瘤手术切除后运动预后的研究。根据永久性和暂时性运动障碍的患者/肿瘤特征、术前状况和术中因素对结果进行分层。使用广义估计方程生成比值比。结果：共审查了1,332个标题和摘要，评估了261篇全文文章。数据来自67项研究，包括2616例患者，其中371例（14%）出现永久性术后运动障碍，465例（18%）出现暂时性运动障碍，其余1780例（68%）无运动障碍。术前运动功能障碍是永久性术后运动功能障碍最重要的预测因素（OR6.40, CI2.82-14.5, p）。结论：术前运动功能障碍是持续或恶化术后运动功能障碍最重要的预测因素。术中MEP改变与永久性和暂时性缺陷相关。高KPS和皮层下肿瘤位置和较低的永久性运动缺陷的几率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Predictors of Permanent and Temporary Motor Deficits in Patients Undergoing Glioma Resection: A Systematic Review and Meta-Analysis

Objective

To identify predictors of permanent and temporary motor deficits in patients undergoing glioma resection.

Methods

A literature search accessed the databases Ovid Medline, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature/EBSCO, PsychInfo, Cochrane, and Wiley for studies reporting motor outcomes following surgical resection of glioma. Outcomes were stratified by patient/tumor characteristics, preoperative condition, and intraoperative factors for both permanent and temporary motor deficits. Generalized estimating equations were used to generate odds ratios.

Results

A total of 1332 titles and abstracts were reviewed resulting in the evaluation of 261 full-text articles. Data were extracted from 67 studies including 2616 patients with 371 (14%) developing permanent postoperative motor deficits, 465 (18%) developing temporary deficits, and the remaining 1780 (68%) having no deficit. Preoperative deficit was the most significant predictor of permanent postoperative motor deficit (odds ratio [OR] 6.40, confidence interval [CI] 2.82–14.5, P < 0.0001), while high preoperative Karnofsky Performance Scale (OR 0.98, CI 0.97–0.99, P < 0.001) and subcortical tumor location (OR 0.14, C 0.030–0.62, P = 0.001) had a lower odds of a permanent deficit. Intraoperative motor-evoked potential changes was a significant predictor of both permanent (OR 5.18, CI 1.99–13.5, P = 0.00075) and temporary (OR 9.44, CI 2.78–32.0, P = 0.0003) motor deficits.

Conclusions

Preoperative motor deficits were the most significant predictors of persistent or worsening postoperative motor deficits. Intraoperative motor-evoked potential changes were associated with both permanent and temporary deficits. High Karnofsky Performance Scale and subcortical tumor location had lower odds of permanent motor deficits.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS