Incidence of and Risk Factors for Transferring Cancer Patients from Rehabilitation to Acute Care Units

Abstract

The aim of this study was to examine the clinical factors associated with transfer from an acute inpatient rehabilitation service to an inpatient oncology service. Retrospective chart review in an inpatient rehabilitation unit within a tertiary cancer center. Participants included consecutive patients admitted to an acute inpatient rehabilitation unit (n = 98). The average age of these patients was 60 yrs old (range from 18 to 86). Main outcomes measures included the frequency of transfer and reason for transfer. Thirty-five percent (34/98) of patients were transferred back to the oncology service during acute rehabilitation, among them, 12% was for planned cancer treatment and 88% for worsening medical conditions. Age, sex, tumor diagnosis, presence of metastatic lesion, and most abnormal laboratory values at rehabilitation admission were not significant factors for transferring. Significant factors for transfers were low albumin (P = 0.04), elevated creatinine levels (P = 0.01), tube feeding (P = 0.03), and a Foley catheter (P = 0.02). Those patients who were transferred back to the oncology service were more likely to die during hospitalization (15%, 5/33) and less likely to be discharged to home (52%, 17/33) compared with patients who were not transferred (2% death, 1/62; 90% home, 56/62, P < 0.0001). Transferring back to the acute oncology service is 35% among patients undergoing acute cancer rehabilitation.