title: Evaluation and pharmacologic management of symptoms in cancer patients undergoing acute rehabilitation in a comprehensive cancer center.
abstract: OBJECTIVE
  To identify cancer patients' symptoms at admission and on discharge from an acute rehabilitation unit, to document the discharge medications used for symptom management, and to assess how symptoms affect lengths of stay (LOS).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Acute inpatient rehabilitation unit within a tertiary cancer center.
  
  
  METHODS
  Ninety-six patients (49 men, 47 women) were admitted to an acute inpatient rehabilitation unit. The median age was 64 years (range, 26-87y).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Edmonton Symptom Assessment Scale (ESAS) scores at admission and on discharge.
  
  
  RESULTS
  The most intense symptom (mean ESAS visual analog scale score +/- standard deviation) on admission was poor appetite (3.7+/-3.3), followed by fatigue (3.4+/-2.6). Similar results were found for the 63 patients with ESAS scores available at both time points. On discharge, poor appetite (2.2+/-2.4) was still the most intense symptom reported, again followed by fatigue (2.2+/-2.1). There were significant improvements in anxiety (P=.001), constipation (P=.001), fatigue (P=.002), pain (P=.003), appetite (P=.004), sense of well-being (P=.01), and insomnia (P=.04). Seventy percent (65/93) of patients received discharge prescriptions for symptom control, with analgesics being the most frequently prescribed. The poor appetite and depression admission scores correlated positively with hospital LOS (P<.001, P=.05, respectively).
  
  
  CONCLUSIONS
  Assessment of symptoms revealed significant symptom burdens in cancer patients undergoing rehabilitation. Pharmacologic interventions for management of symptoms were frequently needed.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA. yguo@mdanderson.org
authors.forename: Ying
authors.initials: Y
authors.lastname: Guo
authors.forename: Beth L
authors.initials: BL
authors.lastname: Young
authors.forename: Susan
authors.initials: S
authors.lastname: Hainley
authors.forename: J Lynn
authors.initials: JL
authors.lastname: Palmer
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy; D001066:Appetite / Q000502:physiology; D019167:Appetite Stimulants / Q000627:therapeutic use; D002173:Cancer Care Facilities; D002400:Cathartics / Q000627:therapeutic use; D003248:Constipation / Q000188:drug therapy / Q000503:physiopathology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005221:Fatigue / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology; D010147:Pain Measurement; D010351:Patient Discharge; D012189:Retrospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000503:physiopathology; D013781:Texas
chemical_list: D000700:Analgesics; D000928:Antidepressive Agents; D019167:Appetite Stimulants; D002400:Cathartics; D006993:Hypnotics and Sedatives