title: Frequency and reasons for return to the primary acute care service among patients with lymphoma undergoing inpatient rehabilitation.
abstract: OBJECTIVE
  To assess the frequency and risk factors for return to the primary acute care service among patients with lymphoma undergoing inpatient rehabilitation.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary referral-based cancer center.
  
  
  METHODS
  All patients with a history of lymphoma admitted to an inpatient rehabilitation between October 1, 2003, and January 30, 2013.
  
  
  METHODS
  Items analyzed from patient records included return to the primary acute care service with demographic information, lymphoma characteristics, medications, hospital admission characteristics, and laboratory values.
  
  
  RESULTS
  A total of 143 unique patient admissions were analyzed, and 54 of these 143 lymphoma inpatient rehabilitation admissions (38%) returned to the primary acute care service. However, 16 of 54 (30%) returned because they needed additional chemotherapy. Excluding patients who returned to the primary acute care service for chemotherapy, statistically significant or approaching statistically significant factors (P < .10) associated with return to the primary acute care service included a creatinine level ≥ 1.3 mg/dL (P = .0002), male gender (P = .001), history of hematopoietic stem cell transplantation (P = .0355), and presence of an intravenous antifungal agent (P = .0717). Of the patients transferred back to the primary acute care service, 13 of 38 (34%) were discharged directly home, 10 of 38 (26%) died in the hospital, 7 of 38 (18%) were transferred to a subacute rehabilitation facility, and 4 of 38 (11%) were transferred to inpatient rehabilitation.
  
  
  CONCLUSIONS
  When excluding patients who returned for chemotherapy, patients with lymphoma who were male, had undergone hematopoietic stem cell transplantation, and had a creatinine level ≥ 1.3 mg/dL demonstrated increased risk for return to the primary acute care service.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, Unit 1414, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030(∗). Electronic address: jfu@mdanderson.org.
authors.forename: Jack B
authors.initials: JB
authors.lastname: Fu
authors.affiliation: Department of Educational Psychology, University of Houston, Houston, TX(†).
authors.forename: Jay
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Educational Psychology, University of Houston, Houston, TX(‡).
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Smith
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, University of Texas M. D. Anderson Cancer Center, Houston, TX(§).
authors.forename: Ki
authors.initials: K
authors.lastname: Shin
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, University of Texas M. D. Anderson Cancer Center, Houston, TX(‖).
authors.forename: Ying
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, University of Texas M. D. Anderson Cancer Center, Houston, TX(¶).
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008223:Lymphoma / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000534:rehabilitation*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult