Early Postoperative Predictors of Independent Walking in Individuals With Brain Tumors

To identify predictors of independent walking at discharge in patients with brain tumors after surgery, including postoperative functional impairments assessed using rehabilitation measurements, and to determine the cutoff score for these predictors.

Prospective observational study.

University Hospital.

Of the 165 hospitalized patients with a newly diagnosed brain tumor after surgery, 105 (N=105) met the inclusion criteria (malignant: n=65, benign: n=40).

Not applicable.

Participants were assessed approximately 7 days after surgery using the following measures: the lower-extremity motor subscale of the Fugl-Meyer Assessment, the Trunk Impairment Scale, the Postural Assessment Scale for Stroke Patients (PASS), FIM, and the presence of cognitive impairment. Participants were divided into 2 groups: independent walking (n=64) and dependent walking (n=41) based on the Functional Ambulation Categories at discharge (mean=42.3d postoperatively).

Multivariate stepwise logistic regression (R²=0.62, p<.001) showed that factors significantly associated with independent walking at discharge were age (p<.001, odds ratio [OR]=0.85, 95% CI, 0.78-0.93), the presence of postoperative complications (p<.05, OR=0.09, 95% CI, 0.01-0.94), and PASS (p<.001, OR=1.34, 95% CI, 1.15-1.57). The cutoff score for PASS using univariate logistic regression was 29 points (area under the curve=0.922, 95% CI, 0.85-0.96, sensitivity=0.84, specificity=0.93).

Early postoperative predictors of independent walking at discharge in patients with brain tumors are younger age, absence of postoperative complications, and a higher PASS score. The PASS cutoff score may serve as a useful early indicator of the potential for independent walking at discharge. These findings may support appropriate and individualized rehabilitation from the early postoperative stage, including discharge support, in patients with brain tumors.