Mapping the Patterns of Care, the Receipt of Palliative Care and the Site of Death For

Mapping the patterns of care, the receipt of palliative care and the site of death for patients with malignant glioma.

Journal of Neuro-oncology

V. Sundararajan*, M.A. Bohensky*, G. Moore, C.A. Brand, C. Lethborg, M. Gold, M.A. Murphy, A. Collins, J. Philip.

Corresponding authorAnna Collins

Centre for Palliative Care

St Vincent’s Hospital, Melbourne

PO Box 2900, Fitzroy VIC 3065 Australia

Ph: +61 3 9416 0000

Fax: +61 3 9416 3919

Email:

Appendix A. Case definition of key clinical covariates based on ICD-10-AM codes
ICD10-AM code / Text Description
tumour Site
Frontal / C711 / Malignant neoplasm of frontal lobe
Temporal / C712 / Malignant neoplasm of temporal lobe
Parietal / C713 / Malignant neoplasm of parietal lobe
Multifocal / C718 / Overlapping malignant lesion of brain
Unspecified site / C719 / Malignant neoplasm of brain, unspecified
Occipital / C714 / Malignant neoplasm of occipital lobe
Cerebrum / C710 / Malignant neoplasm of cerebrum, except lobes and ventricles
Brain stem / C717 / Malignant neoplasm of brain stem
Cerebellum / C716 / Malignant neoplasm of cerebellum
Ventricle / C715 / Malignant neoplasm of cerebral ventricle
Diagnostic Biopsy / 3970600 / Biopsy of brain via osteoplastic craniotomy
4090301 / Biopsy of brain via neuroendoscopy
9000700 / Other diagnostic procedures on skull, brain or cerebral meninges
Resection / 3964000 / Removal of tumour involving anterior cranial fossa
3964200 / Removal of tumour involving anterior cranial fossa with clearance of paranasal sinus extension
3964600 / Removal of tumour involving anterior cranial fossa with radical clearance of paranasal sinus and orbital fossa extensions
3965000 / Removal of tumour involving middle cranial and infratemporal fossae
3965300 / Removal of petroclival and clival tumour
3965800 / Excision of clival tumour, transoral approach
3965801 / Excision of clival tumour, transmaxillary approach
3966000 / Excision of tumour of cavernous sinus
3966001 / Excision of tumour of cavernous sinus with intracranial carotid artery exposure
3966200 / Excision of tumour of foramen magnum, transcondylar approach
3966201 / Excision of tumour of foramen magnum, far lateral suboccipital approach
3970000 / Excision of tumour of skull
3970900 / Removal of tumour of cerebrum
3970901 / Removal of tumour of brain stem
3970902 / Removal of tumour of cerebellum
3971200 / Removal of tumour of cerebral meninges
3971203 / Removal of intraventricular tumour
3971204 / Removal of other intracranial tumour
4157500 / Removal of cerebellopontine angle tumour
4158100 / Removal of tumour involving infratemporal fossa
Symptoms
Headache
G430 – G448 / Migraine/tension-type headache
Weakness/ Paresis
G810-G811, G819 / Hemiplegia
G8200-G8206 / Flaccid paraplegia
G8210-G8216 / Spastic paraplegia
G8220-G8226 / Paraplegia
G8230-G8236 / Flaccid Tetraplegia
G8240-G8246 / Spastic Tetraplegia
G8250-G6256 / Tetraplegia
G830 / Diplegia
G830-G833 / Monoplegia
Seizures
G400-G409 / Epilepsy
G410-G412, G418, G419 / Status epilepticus
R568 / Other and unspecified convulsions
Vomiting
R11 / Nausea and vomiting
Incontinence
N393, N394, R32 / Urinary continence
R15 / Fecal incontinence
Visual disturbance
H530-H536 / Amblyopia ex anopsia, diplopia, colour/night blindness
H538 / Other visual disturbances
Speech/communication or swallowing difficulties
R13 / Dysphagia
R470, R471 / Dysphasia and aphasia, Dysarthria and anarthria
R478 / Other & unspecific speech disturbances
R488 / Other & unspecific symbolic dysfunctions
R490-R492 / Dysphonia, Aphonia, Hypernasality and hyponasality
R498 / Other and unspecified voice disturbances
Cerebral oedema
G936 / Cerebral oedema
Cognitive or behavioural difficulties
R40-R46 / Symptoms and signs involving cognition, perception, emotional state and behaviour
F06 / Other mental disorders due to brain damage and dysfunction and to physical disease
F07 / Personality and behavioural disorders due to brain disease, damage, dysfunction
F05 / Delirium, not induced by alcohol and other psychoactive substances
Poor physical function
R260-R262, R270 / Ataxic or paralytic gait, difficulty walking NEC
R268 / Other & unspecific abnormal gait & mobility
R278 / Other & unspecific lack of coordination
R2981 / Falls
R2989 / Other & unspecific system inv nervous & M/S system
W00-W19 / Falls
Z736 / Limitation of activities due to disability
Z740-Z43 / Reduced mobility (assistance required)

Appendix B. Symptom burden over the care trajectory of patients with primary malignant glioma

Symptoms / Diagnosis
Admission / From 120 days to death / Death Admission
Weakness/paresis / 15% / 18% / 19%
Speech, communication or swallowing difficulties / 14% / 11% / 15%
Seizures / 14% / 17% / 17%
Cognitive or behavioural difficulties / 12% / 14% / 20%
Visual Disturbance / 5% / 2% / 2%
Cerebral Oedema / 4% / 4% / 3%
Poor physical function / 4% / 8% / 8%
Incontinence / 4% / 9% / 21%
Vomiting / 3% / 6% / 7%
Headache / 0% / 0% / 0%