Frequency and Reasons for Return to the Primary Acute Care Service among Lymphoma Patients Undergoing Inpatient Rehabilitation
Identifieur interne : 003629 ( Main/Curation ); précédent : 003628; suivant : 003630Frequency and Reasons for Return to the Primary Acute Care Service among Lymphoma Patients Undergoing Inpatient Rehabilitation
Auteurs : Jack B. Fu ; Jay Lee ; Dennis W. Smith ; Ki Shin ; Ying Guo ; Eduardo BrueraSource :
- PM & R : the journal of injury, function, and rehabilitation [ 1934-1482 ] ; 2013.
Abstract
To assess the frequency and risk factors for return to the primary acute care service among lymphoma patients undergoing inpatient rehabilitation.
Retrospective study.
Tertiary referral-based cancer center.
All patients with a history of lymphoma admitted to inpatient rehabilitation between October 1, 2003 and January 30, 2013.
Items analyzed from patient records included return to the primary acute care service with demographic information, lymphoma characteristics, medications, hospital admission characteristics, and laboratory values.
143 unique patient admissions were analyzed. 54/143 (38%) of lymphoma inpatient rehabilitation admissions returned to the primary acute care service. However, 16/54 (30%) returned due to needing additional chemotherapy. Excluding patients who returned to the primary acute care service for chemotherapy, statistically significant or approaching statistically significant factors (p<.10) associated with return to the primary acute care service included a creatinine greater than or equal to 1.3 milligrams/deciliter (mg/dL) (p=0.0002), male sex (p=0.001), history of hematopoietic stem cell transplant (p=0.0355), and presence of intravenous antifungal agent (p=0.0717). Of those transferred back to the primary acute care service; 13/38 (34%) discharged directly home, 10/38 (26%) died in the hospital, 7/38 (18%) transferred to a subacute rehabilitation facility, and 4/38 (11%) transferred to inpatient rehabilitation.
Chemotherapy was the most common reason for return to the primary acute care service. When excluding patients who returned for chemotherapy, lymphoma patients who are male, who have had a hematopoietic stem cell transplant, and have a creatinine greater than or equal to 1.3 mg/dL demonstrated increased risk for return to the primary acute care service.
Url:
DOI: 10.1016/j.pmrj.2013.12.009
PubMed: 24384360
PubMed Central: 4077984
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Jack B. Fu<affiliation><nlm:aff id="A1">Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center</nlm:aff>
<wicri:noCountry code="subfield">University of Texas MD Anderson Cancer Center</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A2">Department of Educational Psychology, University of Houston</nlm:aff>
<wicri:noCountry code="subfield">University of Houston</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A2">Department of Educational Psychology, University of Houston</nlm:aff>
<wicri:noCountry code="subfield">University of Houston</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A1">Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center</nlm:aff>
<wicri:noCountry code="subfield">University of Texas MD Anderson Cancer Center</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A1">Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center</nlm:aff>
<wicri:noCountry code="subfield">University of Texas MD Anderson Cancer Center</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A1">Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center</nlm:aff>
<wicri:noCountry code="subfield">University of Texas MD Anderson Cancer Center</wicri:noCountry>
</affiliation>
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<wicri:noCountry code="subfield">University of Texas MD Anderson Cancer Center</wicri:noCountry>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To assess the frequency and risk factors for return to the primary acute care service among lymphoma patients undergoing inpatient rehabilitation.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Retrospective study.</p>
</sec>
<sec id="S3"><title>Setting</title>
<p id="P3">Tertiary referral-based cancer center.</p>
</sec>
<sec id="S4"><title>Patients</title>
<p id="P4">All patients with a history of lymphoma admitted to inpatient rehabilitation between October 1, 2003 and January 30, 2013.</p>
</sec>
<sec id="S5"><title>Main Outcome Measures</title>
<p id="P5">Items analyzed from patient records included return to the primary acute care service with demographic information, lymphoma characteristics, medications, hospital admission characteristics, and laboratory values.</p>
</sec>
<sec id="S6"><title>Results</title>
<p id="P6">143 unique patient admissions were analyzed. 54/143 (38%) of lymphoma inpatient rehabilitation admissions returned to the primary acute care service. However, 16/54 (30%) returned due to needing additional chemotherapy. Excluding patients who returned to the primary acute care service for chemotherapy, statistically significant or approaching statistically significant factors (p<.10) associated with return to the primary acute care service included a creatinine greater than or equal to 1.3 milligrams/deciliter (mg/dL) (p=0.0002), male sex (p=0.001), history of hematopoietic stem cell transplant (p=0.0355), and presence of intravenous antifungal agent (p=0.0717). Of those transferred back to the primary acute care service; 13/38 (34%) discharged directly home, 10/38 (26%) died in the hospital, 7/38 (18%) transferred to a subacute rehabilitation facility, and 4/38 (11%) transferred to inpatient rehabilitation.</p>
</sec>
<sec id="S7"><title>Conclusions</title>
<p id="P7">Chemotherapy was the most common reason for return to the primary acute care service. When excluding patients who returned for chemotherapy, lymphoma patients who are male, who have had a hematopoietic stem cell transplant, and have a creatinine greater than or equal to 1.3 mg/dL demonstrated increased risk for return to the primary acute care service.</p>
</sec>
</div>
</front>
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