Decreased bed mobility function is associated with post-discharge mortality for cancer patients in inpatient rehabilitation.

Abstract

The establishment of rehabilitation goals for hospitalized cancer patients depends on accurate medical prognosis and matching goals to clinical timelines. Current tools for estimating prognosis are limited. We hypothesized that bed mobility is a predictor of mortality in cancer patients admitted to inpatient rehabilitation. In a retrospective cohort of 187 subjects with non-neurologic cancer admitted to inpatient rehabilitation, Functional Independence Measure (FIM) scores and 6-month mortality were analyzed. In the cohort, survival rate was 71% at 6 months. In univariate analysis, discharge bed mobility score (OR = 0.75, 95%CI = 0.61 to 0.90, p = 0.003), bed mobility FIM gain (OR = 0.66, 95%CI = 0.51 to 0.85, p = 0.002), and bed mobility FIM efficiency (OR = 0.011, 95%CI = 0.00032 to 0.21, p = 0.006) were inversely associated with 6-month mortality after discharge from IRF. In multivariate analysis with additional motor FIM items, only bed mobility (OR = 0.73, 95%CI = 0.54 to 0.97, p = 0.029) and grooming (OR = 0.79, 95% CI = 0.63 to 0.99, p = 0.041) were independently associated with mortality. Lower discharge and lower change in bed mobility FIM scores are associated with mortality in cancer patients in inpatient rehabilitation. Bed mobility could serve as a clinical tool for estimating medical prognosis in hospitalized cancer patients and should be validated in prospective studies.