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

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

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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; p = 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; p = 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.

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