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Predicting medical prognosis in patients with glioblastoma during inpatient rehabilitation using bed mobility
Tomasz Gruchala1,2, Christopher W Lewis3, Kathryn Abplanalp4
1Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Background:
Determining appropriate suitability and goals for inpatient rehabilitation of patients with glioblastoma, isocitrate dehydrogenase-wildtype (GBM) requires real-time prognostic information. Functional measures, such as bed mobility, are standardized scores that can be assessed by members of the care team at the bedside and may aid medical prognostication.
Objective:
To analyze the association between bed mobility function during inpatient rehabilitation and 6-month survival post rehabilitation in people with GBM.
Design:
Retrospective cohort study.
Setting:
Academic inpatient rehabilitation facility (IRF).
Patients:
One hundred seventy patients with GBM admitted to an IRF over 4.5 years.
Interventions:
Not applicable.
Main Outcome Measure:
Survival 6 months post rehabilitation, regardless of disease progression or events.
Results:
Univariate analyses showed admission (odds ratio [OR] = 1.63, 95% confidence interval [CI] 1.23-2.20; p < .001), discharge (OR = 1.72, 95% CI 1.39-2.16; p <. 001) and gain in bed mobility (OR = 1.64, 95%CI 1.26-2.20; p < .001) were associated with survival. In multivariate analyses adjusting for demographic and clinic variables, admission (OR = 1.91, 95% CI 1.39-2.69; p < .001), discharge (OR = 1.72, 1.38-2.19; p < .001), and gain in bed mobility (OR = 1.62, 95% CI 1.20-2.22; p = .002) were each independently associated with survival. Bed mobility was also independently associated with survival compared to other standard functional independence measures collected in IRF at discharge (OR = 1.88, 95% CI 1.14-3.23; p = .017) and for gain (OR = 1.65, 95% CI 1.10-2.53; p = .018). There was a significant difference in survival between patients with admission bed mobility scores of ≤1 or ≥2 (HR = 3.68, p < .001), discharge scores of ≤1 or ≥2 (HR = 5.72, p<. 001), or a gain of ≤0 or ≥1 (HR = 3.13, p < .001).
Conclusions:
Bed mobility function may serve as a predictor of survival in GBM, suggesting that it could be used during inpatient rehabilitation to help determine functional goals for patients with GBM.
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