10204-nqpc-7 effectiveness and problem of convalescent rehabilitation for independent living in their house of patients with brain tumor

Abstract OBJECTIVE The goal of brain tumor (BT) treatment is to achieve independent living (IL) in the house that KPS (Karnofsky Performance Status) is 70. However, 30% of KPS after postoperative concomitant chemoradiotherapy is between 30 to 60. Therefore, it is necessary to achieve IL in these patients. We report effectiveness for improvement of KPS, achievement of IL, and influence for health-related quality of life (HR-QoL) of convalescent rehabilitation. METHODS 138 patients with BT (average of age: 63, male/female: 76/62) who admitted in our hospital in purpose of rehabilitation, whose KPS were from 40 to 60 were enrolled from 2017. The rate of improvement (RoI) that KPS upgrade by one degree and the rate of IL (RoIL) were evaluated, and the factors to influence them were analyzed. Additionally, HR-QoL using QLQ-C30 and BN-20 on admission and discharge was evaluated. RESULTS While rehabilitation for KPS 50 achieved 70% of RoI and 60% of RoIL, that with KPS40 or less resulted in 40% of RoI and 18% of RoIL. Primary GBM 47cases with KPS60 achieved 83% of RoI and RoIL, and with KPS40 also achieved 27% of RoI and 17% of RoIL. Multivariate analysis revealed that MMSE≥24 contributed to RoI, and MMSE≥24 and KPS≥50 to the RoIL with statistically significance. HR-QoL survey revealed that financial and future uncertainty in patients with BT were higher than that in stroke, QoL scales tended to deteriorate during the hospital, and this tendency was particularly strong in patients with malignancy. CONCLUSIONS Our data revealed that rehabilitation in in patients with BT for KPS 60 or less was significantly effective to achieve IL. On the other hand, it is the issue to improve ADL in patients with KPS40 or less by effective rehabilitation and to approach the improvement of mental health.