Patients with poor mobility who received palliative inpatient rehabilitation services may be at risk for early mortality, according to results of a study published in The Oncologist.

The goal of palliative rehabilitation services is to improve functional outcomes and quality of life. However, the definition of improved functional outcomes and quality of life depend largely on the amount of time a patient has left.

This study is a secondary analysis of patient data collected between 2017 and 2018 at the University of Texas MD Anderson Cancer Center. Patient characteristics were compared between those who had early mortality (60 or fewer days) and those who survived longer after discharge from acute inpatient rehabilitation.


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Median age was 64 years, 50% of patients were men, and the length of hospital stay was 26 days. The most common primary neoplasm types were brain and other nervous systems (23%), hematologic or lymphatic (21%), and bone and connective tissues (15%).

Of the 27 patients with early mortality, more of them were men, had longer hospital stays, poorer mobility at admission and discharge, and received more frequent red blood cell and platelet transfusions than the patients who survived longer.

In the multivariate analysis, early mortality was associated with gender (odds ratio [OR], 2.713; 95% CI, 1.030-7.145; P =.037) and Activity Measure for Post-Acute Care (AM-PAC) Inpatient “Six Clicks” Short Form score (OR, 0.241; 95% CI, 0.073-0.791; P =.022).

These findings may not be generalizable for other centers, and these findings should be confirmed by an independent cohort.

The study authors concluded that early mortality after discharge from palliative rehabilitation was relatively common and patients at higher risk for early mortality had lower AM-PAC scores at admission and discharge and tended to be men.

Reference

Tennison JM, Asher A, Hui D, Javle M, Bassett RL, Bruera E. Palliative rehabilitation in acute inpatient rehabilitation: prognostic factors and functional outcomes in patients with cancer. Oncologist. Published online November 11, 2022. doi:10.1093/oncolo/oyac229