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Predictors of Acute Transfer and Mortality Within 6 Months From Admission to an Inpatient Rehabilitation Facility for Patients With Brain Tumors

Published:November 08, 2021DOI:https://doi.org/10.1016/j.apmr.2021.10.019

      Abstract

      Objective

      To obtain useful information for clinicians in evaluating patients with brain tumors for transfer to and subsequent care in inpatient rehabilitation facilities (IRFs).

      Design

      Retrospective chart review.

      Setting

      Inpatient rehabilitation facility.

      Participants

      A total of 208 adults with either initial or recurrent brain tumors who were admitted to an IRF between January 2017 and December 2018 after an acute hospitalization.

      Interventions

      None

      Main Outcome Measures

      Transfer from an IRF to an acute care hospital and mortality within 6 months from admission to an IRF.

      Results

      Of the 208 patients who met inclusion criteria, 20.2% were transferred to an acute care hospital during the IRF stay, which was associated with prior chemotherapy, steroid use, and laterality of tumor. In total, 36.9% of patients with brain tumors died within 6 months of an IRF admission that was associated with recurrent tumor diagnosis, prior chemotherapy, prior neurosurgical intervention, prior neurostimulant use, use of steroids, isocitrate dehydrogenase and O6-methyl-guanyl-methyl-transferase biomarkers, and laterality and location of tumor.

      Conclusions

      Patients with brain tumors have a notable potential for acute hospital transfer and mortality within 6 months of IRF stay, with several tumor- and treatment-related risk factors. This information can help identify functional goals, identify high risk patients, enable closer clinical monitoring, and facilitate focused care discussions at IRFs.

      Keywords

      List of abbreviations:

      AED (antiepileptic drug), IDH (isocitrate dehydrogenase), IRF (inpatient rehabilitation facility), MGMT (O6-methyl-guanyl-methyl-transferase)
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