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Frequency and Reasons for Return to the Primary Acute Care Service among Lymphoma Patients Undergoing Inpatient Rehabilitation

Identifieur interne : 003629 ( Main/Exploration ); précédent : 003628; suivant : 003630

Frequency 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 Bruera

Source :

RBID : PMC:4077984

Abstract

Objective

To assess the frequency and risk factors for return to the primary acute care service among lymphoma patients undergoing inpatient rehabilitation.

Design

Retrospective study.

Setting

Tertiary referral-based cancer center.

Patients

All patients with a history of lymphoma admitted to inpatient rehabilitation between October 1, 2003 and January 30, 2013.

Main Outcome Measures

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.

Results

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.

Conclusions

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


Affiliations:

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<title>Objective</title>
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<title>Design</title>
<p id="P2">Retrospective study.</p>
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<title>Setting</title>
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<title>Patients</title>
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<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>
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