title: Return to primary service among bone marrow transplant rehabilitation inpatients: an index for predicting outcomes.
abstract: OBJECTIVE
  To assess rehabilitation inpatient risk of return to primary (RTP) service in patients with bone marrow transplant (BMT).
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Inpatient rehabilitation unit within a tertiary referral-based cancer center.
  
  
  METHODS
  All patients with BMT (131) who were admitted a total of 147 times to inpatient rehabilitation between January 1, 2002, and April 30, 2010.
  
  
  METHODS
  None.
  
  
  METHODS
  We analyzed RTP service and demographic information, cancer characteristics, medications, hospital admission characteristics, and laboratory values.
  
  
  RESULTS
  A total of 61 (41%) of 147 of BMT admissions were transferred from the inpatient rehabilitation unit back to the primary service. Of those transferred back, 23 (38%) of 61 died after being transferred back to the primary service. Significant or near-significant relationships were found for a platelet count of <43,000 per microliter (P<.01); a creatinine level of >0.9 milligrams/deciliter (P<.01); the presence of an antiviral agent (P=.0501); the presence of an antibacterial agent (P=.0519); the presence of an antifungal agent (P<.05); and leukemia, lymphoma, or multiple myeloma diagnosis (P<.05). Using 5 of these factors, the RTP-BMT index was formulated to determine the likelihood of return to the primary team.
  
  
  CONCLUSIONS
  Patients with BMT have a high rate of transfer from the inpatient rehabilitation unit back to the primary service. The RTP-BMT index score can be a useful tool to help clinicians predict the likelihood of return to the primary acute care service.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. jfu@mdanderson.org
authors.forename: Jack B
authors.initials: JB
authors.lastname: Fu
authors.forename: Jay
authors.initials: J
authors.lastname: Lee
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Smith
authors.forename: Ying
authors.initials: Y
authors.lastname: Guo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000534:rehabilitation*; D002173:Cancer Care Facilities; D003404:Creatinine / Q000032:analysis; D005260:Female; D006757:Hospital Units; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D007938:Leukemia / Q000453:epidemiology; D016015:Logistic Models; D008223:Lymphoma / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology; D010360:Patient Transfer; D010976:Platelet Count; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D000998:Antiviral Agents; D003404:Creatinine