Article

Pancytopenia, immunosuppression, and other factors may place patients
with multiple myeloma at risk for medical complications.
These patients often
require inpatient rehabilitation. No previous studies have looked at risk factors
for return to the primary acute care service of this patient population.
OBJECTIVE: To determine the percentage of and factors associated with return to
the primary acute care service of multiple myeloma rehabilitation inpatients.
DESIGN: Retrospective review. SETTING: Acute inpatient rehabilitation unit within
a National Cancer Institute Comprehensive Cancer Center. PARTICIPANTS: All
patients with multiple myeloma admitted to the inpatient rehabilitation unit
between March 1, 2004, and February 28, 2015. MAIN OUTCOME MEASURES:
Return to
the primary acute care service was analyzed with demographic information,
multiple myeloma characteristics, medications, laboratory values, and hospital
admission characteristics. RESULTS: One hundred forty-three inpatient
rehabilitation admissions were found during the study period. After we removed
multiple admissions of the same patients and planned transfers to the primary
acute care service, 122 admissions were analyzed. Thirty-two (26%) patients
transferred back to the primary acute care service for unplanned reasons.
Multivariate analysis revealed male gender and thrombocytopenia as significantly
associated with return to the primary acute care service. The median survival of
patients who transferred back to the inpatient primary acute care service was 180
days versus 550 days for those who did not (P < .001). CONCLUSION: Because of
their medical fragility, clinicians caring for rehabilitation inpatients with
multiple myeloma should maintain close contact with the primary oncology service.
Factors associated with an increased risk of transfer back to the primary acute
care service include male gender and thrombocytopenia.
LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS