title: Rehabilitation referrals and outcomes in the early period after hematopoietic cell transplantation.
abstract: In a cohort of inpatient hematopoietic cell transplantation (HCT) recipients, we assessed patterns of referral to rehabilitation treatment, functional performance and short-term outcomes in patients who received post-transplant rehabilitation in comparison with those who did not. Among 201 first-time HCT recipients, 53 (26%) were referred to an inpatient rehabilitation provider, had an assessment of functional performance using the Functional Independence Measure scale and underwent rehabilitation treatments to address functional needs. Patients who received rehabilitation therapy were more likely to be females (P=0.02), older than 60 years of age (P=0.0146), employed (P=0.01), have hypertension (P=0.02), peripheral vascular disease (P=0.01) and pre-transplant Karnofsky Performance Score (KPS) <90 (P=0.02). Mean functional performance scores for transfers and ambulation increased significantly in the group with rehabilitation interventions (P=0.0022 and P<0.0001, respectively). There was no difference between the groups that did and did not receive rehabilitation treatments in 30-day re-admission rates. Patients who are 60 years of age or older, with pre-transplant KPS<90, and pre-transplant hypertension were more likely to be referred for rehabilitation treatments in the early period after HCT. Future studies should be designed to determine the optimal timing and cost effectiveness of functional assessment and rehabilitation treatments in this high-risk population.
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: J
authors.initials: J
authors.lastname: Laine
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: A
authors.initials: A
authors.lastname: D'Souza
authors.affiliation: Wheaton Franciscan-St Joseph Campus, Milwaukee, WI, USA.
authors.forename: S
authors.initials: S
authors.lastname: Siddiqui
authors.affiliation: Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: O
authors.initials: O
authors.lastname: Sayko
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: R
authors.initials: R
authors.lastname: Brazauskas
authors.affiliation: Department of Rehabilitation Medicine, The University of Kansas, Kansas City, KS, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Eickmeyer
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012046:Rehabilitation / Q000379:methods*; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult