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Rehabilitation in primary and metastatic brain tumours

Impact of functional outcomes on survival

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Abstract

Objectives

Patientswith brain tumours have majordisabilities and guarded prognosisbut may benefit from inpatient rehabilitation.The objectives were tocompare functional outcomes inpatients with glioblastoma multiforme(GBM), brain metastasesand other brain tumours, and todetermine predictors of survival.

Methods

Demographic, clinical,functional, and survival data werecollected for 63 patients.Kaplan-Meier and Cox regression wereused for survival analyses.

Results

Functional Independence Measure(FIM™) scores improved fromadmission to discharge for patientswith GBM, brain metastases andother tumours. Estimated mediansurvival was 141 days for brainmetastases, 214 days for GBM and439 days for other tumours. Lowadmission dexamethasone doseand high FIM™ gain predictedbetter survival in GBM. For brainmetastases, high FIM™ gain, lowdexamethasone dose and no organmetastases were positive prognosticfactors.

Conclusions

Patientswith primary and metastatic braintumours achieved functional gainsafter rehabilitation. High functionalimprovement is a significantpredictor of longer survival inbrain metastases and GBM. Thisstudy has implications for rehabilitationin the post-acute managementof patients who have disabilitiesdue to brain tumours.

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Author information

Authors and Affiliations

  1. Division of Neurology, McMaster University, Hamilton, Canada

    V. Tang BSc &  M. Rathbone MB, ChB,PhD, FRCP(C)

  2. Division of Physical Medicine andRehabilitation, McMaster University,Henderson General Hospital, 40 Wing, 711 Concession Street, Hamilton, Canada L8V 1C

    D. Harvey MD, FRCP

  3. Division of Neurosurgery, McMaster University, Hamilton, Canada

    S. Jiang MB, MD, MSc, PhD

  4. Hamilton Health Sciences, Hamilton, Canada

    J. Park Dorsay RN, MN, ACNP(D), CON(D)

Authors
  1. V. Tang BSc
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  2. M. Rathbone MB, ChB,PhD, FRCP(C)
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  3. J. Park Dorsay RN, MN, ACNP(D), CON(D)
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  4. S. Jiang MB, MD, MSc, PhD
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  5. D. Harvey MD, FRCP
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Corresponding author

Correspondence to D. Harvey MD, FRCP.

Additional information

Function scores noted are based on data collectedusing the FIM™ instrument. The 18-item FIM™ Instrument is the property of theUniform Data System for Medical Rehabilitation,a division of UB Foundation Activities,Inc.

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Tang, V., Rathbone, M., Park Dorsay, J. et al. Rehabilitation in primary and metastatic brain tumours. J Neurol 255, 820–827 (2008). https://doi.org/10.1007/s00415-008-0695-z

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  • DOI: https://doi.org/10.1007/s00415-008-0695-z

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