title: Incidence of and risk factors for transferring cancer patients from rehabilitation to acute care units.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Transferring back to the acute oncology service is 35% among patients undergoing acute cancer rehabilitation.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, University of Texas-M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Guo
authors.forename: Lisa
authors.initials: L
authors.lastname: Persyn
authors.forename: J Lynn
authors.initials: JL
authors.lastname: Palmer
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002404:Catheterization; D003404:Creatinine / Q000032:analysis; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D010360:Patient Transfer; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis
chemical_list: D012709:Serum Albumin; D003404:Creatinine