Introduction: Patient-reported outcome measures (PROMs) are increasingly used to assess patients’ perioperative health. The Patient-Reported Outcomes Measurement Information System 29 (PROMIS29) is a well-validated global health assessment instrument, though its utility in cranial neurosurgery is unclear. We studied the value of pre-operative PROMIS29 scores in predicting post-operative outcomes in brain tumor patients.
Methods: We retrospectively reviewed a prospective cohort of adult operative brain tumor patients from a single institution (January 2018-December 2021). Physical health (PH) summary scores were constructed and optimum prediction thresholds for length of stay (LOS), discharge disposition (DD) and 30-day readmission were approximated by finding the Youden index of the associated receiver operating characteristic curves. Bivariate analyses was used to study the distribution of low (z-score ≤-1) vs. high (z-score >-1) PH scores according to baseline characteristics. Logistic regression models quantified the association between preoperative PH summary scores and post-operative outcomes. Results were considered statistically significant at p-values ≤0.05.
Results: The study included 157 patients. Mean age was 55.4 years, women (57.96%) overnumbered men, and benign tumors predominated (56.69%). Bivariate analyses showed those with low PH summary score (poor baseline physical health) were more likely to have a malignant tumor, a non-elective admission, and worse outcomes. In multivariate analysis, low PH summary score independently predicted greater odds of longer LOS (OR:6.09, p=0.003), non-home DD (OR:4.25, p=0.02) and 30-day readmission (OR:3.93, p=0.02).
Conclusion : The PROMIS29 PH summary score predicts short-term post-surgical outcomes (LOS, DD and 30-day readmission). This score may be easily incorporated into clinical workflows to forecast postsurgical outcomes in brain tumor patients in real-time.
