Restorative Care for Advanced Cancer Patients: A Retrospective Clinical Audit of Outcomes for Patients Admitted to An Inpatient Palliative Care Unit (#290)
Background: Patients with advanced cancer have many unmet rehabilitation needs12 3 4 . Restorative care is a subset of rehabilitation that aims to improve quality of life through restoration or maintenance of function. Restorative care outcomes for advanced cancer patients in palliative care units have not adequately been assessed.
Aims: The objectives are to examine the outcomes for oncology patients referred for restorative care in a palliative care unit, including discharge destination, performance status and length of stay.
Methods: Retrospective clinical audit of consecutive patients with an advanced malignancy admitted to Calvary Health Care Bethlehem for restorative care from July 2010 to December 2011.
Results: 75 admissions met inclusion criteria. Mean age was 76.3 years and 39 (52%) were male. The most common diagnosis was metastatic lung cancer (30.67%). 15 patients (26.67%) were discharged home, 48 (64%) died, and 12 (15%) were transferred. Of the patients discharged home only 4 (5.3% all patients) improved their performance status. Patients discharged home had a significantly better Australia-modified Karnofsky Performance Status (AKPS) and Resource Utilisation Groups-Activities of Daily Living (RUG-ADL) scores upon admission than others (both p<0.05).
Conclusion: The majority of oncology patients referred for restorative care died during the admission, with only 26.67% being discharged home. Patients discharged home most commonly experienced maintenance and not improvement in performance status. A successful discharge home was associated with a shorter length of stay. Implications and recommendations for successful restorative care for patients with advanced malignancy will be presented.
- Santiago-Palma J, Payne R. Palliative Care and Rehabilitation. Cancer. 2001;92:1049-52.
- Okamura H. Importance of rehabilitation in cancer treatment and palliative medicine. Japanese Journal of Clinical Oncology. 2011 Jun;41(6):733-8.
- Movsas SB, Chang VT, Tunkel RS, Shah VV, Ryan LS, Millis SR. Rehabilitation needs of an inpatient medical oncology unit. Archives of Physical Medicine Rehabilitation. 2003 Nov;84:1642-6.
- Schleinich MA, Warren S, Nekolaichuk C, Kaasa T, Watanabe S. Palliative care rehabilitation survey: a pilot study of patients' priorities for rehabilitation goals. Palliative Medicine. 2008 Oct;22(7):822-30.