Early postoperative predictors of independent walking in patients with brain tumors.
prospective_cohort · Level II
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- Also identified by DOI 10.1016/j.apmr.2025.09.036.
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Abstract
To identify the predictors of independent walking at discharge in patients with brain tumor after surgery, including postoperative functional impairments assessed using rehabilitation measurements and to determine the cut-off score for these predictors. Prospective observational study. Osaka Medical and Pharmaceutical University Hospital. Of the 165 hospitalized patients with newly diagnosed brain tumor after surgery, 105 met the inclusion criteria (malignant: n = 65, benign: n = 40). Not applicable. The participants were assessed approximately 7 days after surgery using the following measurements: lower-extremity motor subscale of the Fugl-Meyer Assessment, Trunk Impairment Scale, Postural Assessment Scale for Stroke Patients (PASS), Functional Independence Measure, and presence of cognitive impairment. Participants were divided into two groups: independent walking (n = 64) and dependent walking (n = 41) based on the Functional Ambulation Categories at discharge (mean: 42.3 days postoperatively). Multivariate stepwise logistic regression (R<sup>2</sup>: 0.62, p < 0.001) showed that factors significantly associated with independent walking at discharge were age (p < 0.001, odds ratio [OR]: 0.85, 95% confidence intervals [CI]: 0.78-0.93), presence of postoperative complications (p < 0.05, OR: 0.09, 95% CI: 0.01-0.94), and PASS (p < 0.001, OR: 1.34, 95% CI: 1.15-1.57). The cut-off 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 higher PASS score. The PASS cut-off 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 tumor.