Cancer rehabilitation: a barometer for survival?

Abstract

This pilot study was conducted to describe the clinical features and functional outcomes of patients attending inpatient rehabilitation for cancer-related deconditioning and neurological deficits and to explore factors associated with improved survival. Using a retrospective audit, demographic characteristics, discharge outcomes, survival time, and functional status as measured by Functional Independence Measure (FIM) were recorded for 73 patients. Clinical status was estimated by Karnofsky Performance Status Scale (KPS). Cox regression was used to assess factors associated with improved survival following discharge from rehabilitation. Significant functional gains following rehabilitation were observed in total FIM (p = 0.02), motor FIM (p = 0.001), and KPS (p = 0.003). Length of survival ranged from 9.0 to 25.0 months, with 26 cases surviving to the end of study (censored). Patients scoring a total FIM of ≥80 survived significantly longer than patients scoring <80 (p = 0.002). At discharge, motor FIM scores (p = 0.004), FIM Efficiency (p = 0.001), KPS scores (p = 0.022), ambulation ability (p = 0.026), return to home (p = 0.009), and receipt of in-home services (p = 0.045) were significantly associated with improved survival. Functional improvement achieved through inpatient rehabilitation was associated with prolonged survival among cancer patients. Rehabilitation leading to improved independence among cancer patients may act as a marker of those with greater likelihood of better prognosis.