Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Survival of patients with solid-organ malignancies referred to Nepean Hospital Rehabilitation services between 2018-2020 (#212)

Vikram Joshi 1 , Michael Que 2 , Sharon Wong 1 , Isabel Scalia 3 , Laurence Chu 1 , Deme Karikios 2 4 , Alexander Murphy 4
  1. Department of Rehabilitation Medicine, Nepean Hospital, Nepean and Blue Mountains Local Health District, Kingswood, New South Wales, Australia
  2. Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Kingswood, New South Wales, Australia
  3. Department of Internal Medicine, Royal Brisbane Hospital, Brisbane, Queensland, Australia
  4. Nepean Cancer & Wellness Centre, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia

Background:

Cancer survivorship is characterised by increasing complexity of impairments related to disease and treatment. Inpatient rehabilitation of patients with cancer aims to improve functional outcomes and independence. We aimed to describe patients referred for rehabilitation at Nepean Hospital, a tertiary-level acute facility, and ascertain any association with overall survival (OS).

Methods:

Retrospective review of adults referred to rehabilitation with solid-organ malignancies. Primary endpoints included: OS, change in Functional Independence Measure (FIM) score and FIM efficiency. Multivariate analysis using Cox proportional hazards with OS as the dependent variable was undertaken. Updated analysis with expanded data is reported.

Results:

144 patients were referred for rehabilitation between January 1, 2018 to December 31, 2020. Median age was 70 years; 95 (66%) were male, 117 (81%) had Stage IV disease and 121 (84%) were ECOG 3-4. Urogenital, lung and gastrointestinal cancers accounted for 64%. 32 (22%) patients had curative treatment planned, whilst 31 (22%) were for supportive care only. Median Charlson Comorbidity Index was 4. 108 patients were accepted for inpatient rehabilitation (84 within Nepean Hospital). Median follow-up was 5.4 months. Median OS was 6.2 months (95%CI: 5.0-9.9). Acceptance to rehabilitation correlated with OS (HR 0.48, 95%CI 0.30-0.78, p=0.003) after adjustment for age, treatment intent, ECOG, co-morbidities and stage. Secondary endpoints included: re-admission within 30 days of discharge (22, 20%), transfer back to acute care (21, 19%) and death in hospital after rehabilitation (16, 15%). Of patients accepted at Nepean Hospital: median rehabilitation duration was 16 days with 57 (72%) discharged home, median FIM change was 16 points, median FIM efficiency of 0.83 points/day, 17 patients (22%) had concurrent anti-cancer treatment. FIM score >80 on discharge (p=0.0071), FIM change (p<0.001) and FIM efficiency (p=0.020) correlated with better survival.

Conclusions:

Patients with cancer selected for rehabilitation have improved function and may experience longer survival.