Original articleInpatient Cancer Rehabilitation: A Retrospective Comparison of Transfer Back to Acute Care Between Patients With Neoplasm and Other Rehabilitation Patients
Section snippets
Data
The dataset consists of first-time, acute rehabilitation discharges at a large, academic rehabilitation facility from 2001 to 2005. Information was obtained from an institutional database that included impairment group, ICD-9 codes, age, sex, race, comorbid conditions, rehabilitation type (derived from the case-mix group number), tier status, admission FIM motor and cognitive scores, and discharge destination. The first author (EA) conducted chart reviews to determine the reason for transfer
Results
There were 3160 discharges during the study period, of which 359 were removed because they were not the initial rehabilitation stay. The final dataset included 2801 first-time discharges (table 1). The malignant neoplasm group was older than controls and also older than patients with neoplasm with benign tumors; no other major demographic differences were found. The prevalence of heart disease was significantly higher in the malignant cases, as was bladder infection in all neoplasm cases. Tier
Discussion
The main aim of this study was to compare the rate of transfer from acute rehabilitation between patients with and without neoplasm, which we found to be approximately 21% and 10%, respectively. The adjusted analysis found patients with neoplasm had about 2.5 times the odds of unplanned transfer to acute medical-surgical floors compared with controls, whether the neoplasm was malignant (OR=2.5) or benign (OR=2.4). Although primary analysis showed that patients with malignant neoplasm were
Conclusions
Rehabilitation patients with neoplasm are more likely to require transfer than patients without neoplasm, with the exception of non-CNS cases. Patients with neoplasm appear more susceptible to infection as the reason for transfer, whereas cardiopulmonary reasons predominate among patients without neoplasm. Development of care strategies that more aggressively prevent and/or treat infection may be warranted. Further study is needed to determine whether these results can be generalized to other
Acknowledgments
We thank John Chae, MD, for his assistance in the development of this project and statistical guidance, and Theresa Fitzgerald, OTR, for assistance with the database.
References (20)
- et al.
Risks of hospital transfer and mortality during stroke rehabilitation
Arch Phys Med Rehabil
(2003) - et al.
Characteristics of persons rehospitalized after stroke rehabilitation
Arch Phys Med Rehabil
(2001) Medical complications experienced by a cohort of stroke survivors during inpatient, tertiary-level stroke rehabilitation
Arch Phys Med Rehabil
(2004)- et al.
Risk factors for acute care transfer among traumatic brain injury patients
Arch Phys Med Rehabil
(1997) - et al.
Functional outcome after brain tumor and acute stroke: a comparative analysis
Arch Phys Med Rehabil
(1998) - et al.
Neoplastic versus traumatic spinal cord injury: an outcome comparison after inpatient rehabilitation
Arch Phys Med Rehabil
(1999) - et al.
Functional outcomes of inpatient rehabilitation in persons with brain tumors
Arch Phys Med Rehabil
(1998) - et al.
Functional outcome following rehabilitation of the cancer patient
Arch Phys Med Rehabil
(1996) - et al.
Functional recovery in cancer rehabilitation
Arch Phys Med Rehabil
(2000) Medicare hospital manual. Section 211: inpatient hospital stays for rehabilitation care
Cited by (53)
Using Performance Status to Identify Risk of Acute Care Transfer in Inpatient Cancer Rehabilitation
2024, Archives of Physical Medicine and RehabilitationAcute Inpatient Rehabilitation Improves Function Independent of Comorbidities in Medically Complex Patients
2022, Archives of Rehabilitation Research and Clinical TranslationInpatient rehabilitation outcome measures in persons with brain and spinal cord cancer
2018, Central Nervous System Cancer RehabilitationCancer rehabilitation continuum of care and delivery models
2018, Central Nervous System Cancer Rehabilitation
Supported by the National Institutes of Health (grant no. K12- HD01097).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.