Simplifying Prognosis for Cancer Patients in Inpatient Rehabilitation: Bed Mobility Correlates With 6-Month Mortality

Abstract

<h3>Research Objectives</h3> Prior studies have shown that lower aggregate Functional Independence Measure (FIM) scores correlate with poor outcomes in cancer patients. However, in determining appropriate functional goals for cancer patients, clinicians would benefit from simplified tools that determine prognostic timelines and aid in developing appropriate functional goals. Bed mobility is an easily assessed measure of function in the inpatient setting. Our objective was to determine the association between bed mobility and mortality in patients with cancer receiving inpatient rehabilitation. <h3>Design</h3> Retrospective cohort study. <h3>Setting</h3> Inpatient Rehabilitation Facility (IRF). <h3>Participants</h3> Included: 143 adult patients over 187 separate admissions to an IRF tied to cancer or its treatment. Excluded: Patients with cancers localized to the central nervous system. <h3>Interventions</h3> Multidisciplinary inpatient rehabilitation consistent with Medicare criteria. <h3>Main Outcome Measures</h3> 6-month mortality post-IRF admission. Functional Independence Measure (FIM) motor items (bed mobility = Bed transfer FIM), six-minute walk test (6MWT), handgrip strength (GS). <h3>Results</h3> Univariate linear regressions showed that bed transfer FIM at discharge, gain, and efficiency each inversely correlated with 6-month mortality (p < 0.01). Cancer patients with discharge bed transfer FIM < 3 or FIM gain < 2 had increased odds of 6-month mortality (OR=3.0, p < 0.01). In multivariate analyses including age, cancer type, and motor FIM items, decreased bed mobility was independently associated with mortality (p < 0.01). Compared to 6MWT and GS in a multivariate analysis, bed mobility was independently associated with mortality (p=0.02). <h3>Conclusions</h3> The present study suggests that bed mobility in inpatient rehabilitation does have an independent relationship to 6-month mortality. In future studies, clinicians could use bed mobility to help tailor rehabilitation interventions to a cancer patient's prognosis. <h3>Author(s) Disclosures</h3> None.