From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, Massachusetts (VG-K, SEK, RG, RZ, MK, JS, JCS); Harvard Medical School, Boston, Massachusetts (VG-K, SEK, RZ, MK, JS, JCS); and Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (JM).
Am J Phys Med Rehabil. 2018 Jul;97(7):514-522. doi: 10.1097/PHM.0000000000000911.
This study describes characteristics and trends of inpatient rehabilitation among cancer patients within the United States over a 13-yr period.
This was a retrospective study of data from the Uniform Data System for Medical Rehabilitation from 2002 to 2014. Patients older than 17 yrs admitted to inpatient rehabilitation facilities with a diagnosis of malignant cancer were included. Trends of rehabilitation outcomes including length of stay, Functional Independence Measure (FIM) Instrument scores, and discharge location were examined.
Data from 115,570 cancer patients were evaluated. Mean age was 66 ± 14 yrs and 49% were women. Mean length of stay decreased over time (2002: 14 days to 2014: 13 days; P < 0.0005). Patient's admission total FIM scores decreased over time (2002: 68 ± 18 to 2014: 61 ± 16; P < 0.0005). The FIM change score increased over time (2002: 19 ± 16 to 2014: 25 ± 17; P < 0.0005). The greatest significant functional gains occurred in self care and transfers. Most patients (>70%) were discharged to the community.
Cancer patients receiving acute inpatient rehabilitation demonstrated significant improvements in functional outcomes from admission to discharge. Cancer patients became more independent in important activities of daily living, thereby potentially reducing caregiver burden and ensuring safer discharges back to the community. This study suggests potential benefit of inpatient rehabilitation for appropriate cancer patients.
本研究描述了美国 13 年来癌症患者住院康复的特点和趋势。
这是一项对 2002 年至 2014 年医疗康复统一数据系统数据的回顾性研究。纳入了年龄大于 17 岁、被诊断为恶性肿瘤并入住住院康复设施的患者。研究了康复结果的趋势，包括住院时间、功能独立性测量（FIM）仪器评分和出院地点。
评估了 115570 名癌症患者的数据。平均年龄为 66 ± 14 岁，49%为女性。平均住院时间随时间推移而减少（2002 年：14 天至 2014 年：13 天；P < 0.0005）。患者入院时的总 FIM 评分随时间推移而降低（2002 年：68 ± 18 至 2014 年：61 ± 16；P < 0.0005）。FIM 变化评分随时间推移而增加（2002 年：19 ± 16 至 2014 年：25 ± 17；P < 0.0005）。最大的显著功能改善发生在自我护理和转移方面。大多数患者（>70%）出院到社区。
接受急性住院康复治疗的癌症患者在入院至出院期间的功能结果显著改善。癌症患者在重要的日常生活活动中变得更加独立，从而有可能减轻照顾者的负担，并确保更安全地返回社区。本研究表明，住院康复对适当的癌症患者可能有益。
