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Frequency and reasons for unplanned transfer to the primary acute care service of inpatient rehabilitation glioblastoma multiforme patients

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Abstract

Purpose

To determine the percentage of and factors associated with unplanned transfer to the acute care service of glioblastoma multiforme acute rehabilitation inpatients.

Methods

Retrospective review of glioblastoma multiforme acute rehabilitation inpatients admitted 4/1/2016–3/31/2020 at a National Cancer Institute Comprehensive Cancer Center.

Results

One hundred thirty-nine consecutive admissions of unique glioblastoma multiforme acute rehabilitation inpatients were analyzed. Fifteen patients (10.7%, 95% confidence interval 6.5–17.1%) were transferred to the acute care service for unplanned reasons. The most common reasons for transfer back were neurosurgical complication 6/15(40%), neurologic decline due to mass effect 4/15(26.7%), and pulmonary embolism 2/15(13.3%). Older age (p = 0.010), infection prior to acute inpatient rehabilitation transfer (p = 0.020), and lower activity measure of post-acute care 6-click basic mobility scores (p = 0.048) were significantly associated with transfer to the acute care service. Patients who transferred to the acute care service had significantly lower overall survival than patients who did not transfer off (log-rank test p = 0.001).

Conclusion

Acute inpatient physiatrists should closely monitor patients for neurosurgical and neurologic complications. The variables significantly associated with transfer to the acute care service may help identify patients at increased risk for medical complications who may require closer observation.

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Data Availability

The data that support the findings of this study are available upon request from the corresponding author, JBF.

Abbreviations

AMPAC :

Activity measure of post-acute care

DNA :

Deoxyribonucleic acid

FIM :

Functional independence measure

HMO :

Health maintenance organization

IRF :

Acute inpatient rehabilitation

GBM :

Glioblastoma multiforme

MMT :

Manual muscle testing

NCI :

National Cancer Institute

TBI :

Traumatic brain injury

WHO :

World Health Organization

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Funding

This study has been supported in part by the M.D. Anderson Cancer Center support grant # CA 016672.

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Authors and Affiliations

  1. Department of Palliative, Rehabilitation and Integrative Medicine, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1414, Houston, TX, 77030, USA

    Jack B. Fu, Ekta Gupta, An T. Ngo-Huang & Ying Guo

  2. Department of Physical Therapy, Fukushima Medical University, Fukushima, Japan

    Shinichiro Morishita

  3. Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Clark R. Andersen

  4. Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jessica P. Engle

Authors
  1. Jack B. Fu
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Contributions

JBF, EG, SM, AN, JPE, and YG participated in concept and design. Material preparation and data collection were performed by JBF and EG. Statistical analysis was performed by CRA. The first draft of the manuscript was written by JBF and EG, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jack B. Fu.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the University of Texas MD Anderson Cancer Center Institutional Review Board.

Consent to participate

Due to the retrospective nature of the study, the University of Texas MD Anderson Cancer Center Institutional Review Board granted a waiver of informed consent and authorization in compliance with federal and institutional guidelines.

Consent to publish

No identifiable individual personal data (including details, images or videos) has been published.

Competing interests

The authors declare no competing interests.

Disclosures

Jack B. Fu, MD, and Ekta Gupta, MD, contributed equally. Ekta Gupta is a co-first author. This study was partially presented as a poster abstract at the Virtual 98th American Congress of Rehabilitation Medicine Annual Conference, September 27, 2021. Supported in part by the M.D. Anderson Cancer Center support grant # CA 016672. We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, if applicable, we certify that all financial and material support for this research (e.g., NIH or NHS grants) and work are clearly identified in the title page of the manuscript.

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Fu, J.B., Gupta, E., Morishita, S. et al. Frequency and reasons for unplanned transfer to the primary acute care service of inpatient rehabilitation glioblastoma multiforme patients. Support Care Cancer 31, 122 (2023). https://doi.org/10.1007/s00520-023-07591-z

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