Factors Predicting Cognitive Impairment in Postoperative brain tumor patients
Keywords:
cognitive impairment, disability, nutritional status, comorbidity, Postoperative brain tumor patientsAbstract
Objective: To study the predictive powers of disability, comorbidity and nutritional status
on cognitive impairment in postoperative brain tumour patients at their frst post-discharge
follow-ups.
Design: Predictive cross-sectional study.
Methodology: This study was conducted on a sample of 77 pairs of postoperative brain tumor patients and their caregivers at their frst post-discharge follow-ups at the neurosurgery outpatient department of a super-tertiary hospital in Bangkok. Data were collected using 1) the Charlson Comorbidity Index (CCI); 2) the Disability Rating Scale (DRS); 3) the Nutrition Alert Form (NAF); and 4) the Mini-Mental State Examination (MMSE). Stepwise regression analysis was employed for statistical analysis.
Results: The subjects were averagely aged 50.32 years (SD ± 12.82), and cognitive impairment was detected in 94.7% of the subjects, at a mean severity level of 17.87 (SD = 4.66). The subjects’ average degrees of disability (6.39; SD = 2.47) and malnutrition (10.47; SD = 3.19) were moderate, whilst their average degree of comorbidity (1.51; SD = 2.32) was low.
Disability and nutritional status were capable of predicting 63.1% of cognitive impairment
in postoperative brain tumor patients. Disability was identifed as the most powerful predictor
for cognitive impairment (β = -0.678, p < .01), over malnutrition (β = -0.195, p < .05),
whereas comorbidity did not have any signifcant predictive power.
Recommendations: It is recommended that nurses screen cognitively impaired brain tumour patients before the operation, before discharge and during their frst post-discharge follow-ups. The screening should be conducted with the patients’ nutritional status and disability taken into consideration, in order to provide them with proper care and advice. The post-screening information can also be used to facilitate case-by-case care coordination between healthcare teams.
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