Rehabilitation in primary and metastatic brain tumours: impact of functional outcomes on survival.
OBJECTIVE
Patients with brain tumours have major disabilities and guarded prognosis but may benefit from inpatient rehabilitation.The objectives were to compare functional outcomes inpatients with glioblastoma multiforme(GBM), brain metastases and other brain tumours, and to determine predictors of survival.


METHODS
Demographic, clinical,functional, and survival data were collected for 63 patients.Kaplan-Meier and Cox regression were used for survival analyses.


RESULTS
Functional Independence Measure(FIM ) scores improved from admission to discharge for patients with GBM, brain metastases and other tumours. Estimated median survival was 141 days for brain metastases, 214 days for GBM and 439 days for other tumours. Low admission dexamethasone dose and high FIM gain predicted better survival in GBM. For brain metastases, high FIM gain, low dexamethasone dose and no organ metastases were positive prognostic factors.


CONCLUSIONS
Patients with primary and metastatic brain tumours achieved functional gains after rehabilitation. High functional improvement is a significant predictor of longer survival in brain metastases and GBM. This study has implications for rehabilitation in the post-acute management of patients who have disabilities due to brain tumours.
Tang
V
V
Division of Neurology, McMaster University, Hamilton, Canada.
Rathbone
M
M
Park Dorsay
J
J
Jiang
S
S
Harvey
D
D
D000203:Activities of Daily Living; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D001932:Brain Neoplasms / Q000150:complications / Q000401:mortality / Q000534:rehabilitation* / Q000556:secondary; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005909:Glioblastoma / Q000150:complications / Q000401:mortality / Q000534:rehabilitation*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D003907:Dexamethasone