Disclosures: Ishan Roy, MD, PhD: No financial relationships or conflicts of interest
Objective : In our prior work, cancer related cachexia was associated with negative functional outcomes during cancer inpatient rehabilitation (IPR). However, the effects of cachexia on independence after rehabilitation has not been characterized. The present study aimed to determine if cachexia in cancer patients, has an impact on their discharge disposition after completion of IPR.
Design: Retrospective cohort study
Setting : Academic Inpatient Rehabilitation Facility (IRF)
Participants : 330 admissions of 250 adult patients admitted to oncologic rehabilitation services.
Interventions: Details regarding each patient’s oncologic history, acute care course, IPR course and discharge destination were collected. Five non-exclusive cohorts of patients at risk of cachexia syndrome were identified by either consensus weight based criteria or by lab markers of protein deficiency. The cohorts were rapid weight loss (RWL, >5% body weight loss during preceding acute care stay), chronic weight loss (CWL, >5% body weight loss during preceding 6 month ambulatory course), pre-cachexia (0-5% body weight loss in preceding 6 months), low creatinine ( < 0.6mg/dL), and low albumin ( < 3.5g/dL).
Main Outcome Measures: Discharge destination after IPR
Results: For cancer patients in IPR, transfer back to acute care, under either urgent or non-urgent circumstances, was associated with low creatinine (OR=2.0, p=0.02) and trended towards association with CWL (OR=1.8, p=0.05) and RWL (OR=1.8, p=0.07). After IPR, discharge to a skilled nursing facility rather than home was associated with RWL (OR=2.7, p=0.02). By contrast, amongst those cancer patients who were discharged home, low albumin was associated with need for homebound rather than outpatient therapy services (OR=14.5, p=0.001).
Conclusions: The presence of cachexia is associated with decreased independence for cancer patients after receiving inpatient rehabilitation. Patients with specific markers of cachexia may be more likely to discharge to a skilled facility, need homebound therapy, or transfer back to acute care. Further investigation is needed into individualized rehabilitation strategies for cancer patients with cachexia.
Level of Evidence: Level III
To cite this abstract in AMA style:
Roy I, Jayabalan P, Bhakta A, Marquez ER, Huang KI, Spangenberg J. Cachexia Syndrome Impacts Cancer Patient Discharge Disposition After Inpatient Rehabilitation [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/cachexia-syndrome-impacts-cancer-patient-discharge-disposition-after-inpatient-rehabilitation/. Accessed May 9, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/cachexia-syndrome-impacts-cancer-patient-discharge-disposition-after-inpatient-rehabilitation/