INCIDENCE AND ASSOCIATIONS OF UNPLANNED ACUTE CARE UNIT READMISSIONS OF PRIMARY BRAIN TUMOUR PATIENTS DURING REHABILITATION: A RETROSPECTIVE STUDY

TL;DR

This study found that 15.9% of Asian brain tumor patients in rehabilitation were unexpectedly readmitted to acute care units, often due to surgical complications or infections.

Contribution

The study identifies risk factors and common causes of unplanned readmissions in Asian primary brain tumor patients during rehabilitation.

Findings

15.9% of patients experienced unplanned acute care unit readmissions.

Neurosurgical complications and non-neurosurgical infections were the most common causes of readmission.

Longer acute hospitalization increased readmission risk, while higher motor function scores reduced it.

Abstract

To examine incidence and associations for unplanned Acute Care Unit Readmissions (ACURs) in Asian primary brain tumour patients.

A retrospective single-centre cohort study.

A total of 173 Asian primary brain tumour patients undergoing inpatient rehabilitation in a tertiary rehabilitation centre.

Primary outcome was unplanned ACUR. Logistic regression analysis was used to determine associations with patients who had an unplanned ACUR.

Altogether, the majority of patients had low-grade (World Health Organization Class I and II) tumours (76.9%), whilst 32 (18.5%) patients had glioblastoma multiforme tumours. Unplanned ACUR occurred in 27 (15.9%) patients, with the 2 most common causes being neurosurgical complications (37.0%) and non-neurosurgical infections (25.9%). Significant risk factors for ACUR patients were a longer acute hospitalization stay (odds ratio = 1.024; 95% confidence interval [CI] = 1.01–1.04; p = 0.007), whereas a higher admission motor Functional Independence Measure was protective against unplanned ACUR (odds ratio = 0.945; 95% CI = 0.915–0.977; p = 0.001).

Despite rehabilitation goals of prevention of complications, patients with primary brain tumours undergoing inpatient rehabilitation continue to demonstrate significant unplanned ACUR rates (15.9%) with neurosurgical complications being common. These findings underscore the importance of continued vigilance, access to and coordination of neurosurgical care and management beyond the acute surgical phase, in order to ensure optimal outcomes.

Inpatient rehabilitation is vital for recovery in patients with primary brain tumours. However, some of these patients may experience medical complications, which require an interruption in their rehabilitation and a transfer to acute hospital. This study aimed to understand how frequent and why Asian patients with primary brain tumours are readmitted to acute care units after starting rehabilitation. In our study, we found 15.9% of patients were unexpectedly readmitted to acute care units. The most common reasons for these readmissions were complications related to brain tumour and infections. Key factors influencing readmission included a longer initial hospital stay, which increased the likelihood of readmission, and a higher motor function score upon admission, which made readmission less likely. Even though rehabilitation aims to prevent complications, primary brain tumour patients still face a notable risk of readmission due to complications. This highlights the need for careful monitoring and ongoing care even during inpatient rehabilitation.