Ann Rehabil Med.  2018 Jun;42(3):477-482. 10.5535/arm.2018.42.3.477.

Factors Associated With Discharge Destination in Advanced Cancer Patients With Bone Metastasis in a Japanese Hospital

• Hayashi K
• Yahata T
• Muramoto R
• Yamamoto N
• Takeuchi A
• Miwa S
• Higuchi T
• Abe K
• Taniguchi
• Aiba H
• Araki Y
• Tsuchiya H

• KMID: 2417841
• DOI: http://doi.org/10.5535/arm.2018.42.3.477

Abstract

OBJECTIVE
To analyze patient characteristics of cancer rehabilitation and outcomes at our hospital.
METHODS
This retrospective study analyzed 580 patients, who underwent cancer rehabilitation at our hospital and rehabilitation outcome after therapy were investigated. The relationship between the initial Barthel index and discharge outcomes was investigated, with a special focus on cancer patients with bone metastasis. The Barthel index and performance status (Eastern Cooperative Oncology Group) before and after rehabilitation were analyzed, and threshold value of home discharge was calculated from a receiver operating characteristic curve (ROC). General criteria for home discharge from our hospital included independence in performing basic activities of daily living such as bathing, feeding, and toileting or availability of home support from a family member/caregiver.
RESULTS
The outcomes after rehabilitation among all the patients were as follows: discharge home 59%, death 13%, and others 27%. Statistical differences were observed between the initial and final values of the Barthel index in patients with bone metastasis, who could be discharged home (p=0.012). ROC analysis of the initial Barthel index for predicting home discharge revealed a threshold value of 60, sensitivity of 0.76, and specificity of 0.72.
CONCLUSION
The patients with bone metastasis had a lower rate of home discharge and a higher rate of mortality than all the study patients who underwent cancer rehabilitation at our hospital. It is proposed that at the time of initiation of rehabilitation for patients with bone metastasis, an initial Barthel index lower than 60 might predict a worse outcome than home discharge.

Keyword

Neoplasms; Rehabilitation; Treatment outcome

MeSH Terms

Activities of Daily Living
Asian Continental Ancestry Group*
Baths
Humans
Mortality
Neoplasm Metastasis*
Rehabilitation
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Treatment Outcome

Figure

• 

  Fig. 1. ROC analysis of initial Barthel index for predicting home discharge. AUC=0.82 (95% confidential interval, 0.73–0.91), threshold value=60, sensitivity=0.76, specificity=0.72. ROC, receiver operating characteristic; AUC, area under the curve.

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