Article

Functional impairments from central nervous system (CNS) dysfunction
experienced by pediatric patients with cancer diagnoses are well documented.
However, little is known of these patients' functional outcomes and potential
complications while receiving inpatient rehabilitation services. OBJECTIVE: To
compare functional outcomes and unplanned transfer rates of pediatric patients
with impairments associated with CNS dysfunction between those with primary
cancer diagnoses and noncancer diagnoses while receiving inpatient rehabilitation
care. DESIGN: Retrospective comparison cohort study. SETTING: Inpatient
rehabilitation unit within a regional tertiary care pediatric hospital.
PARTICIPANTS: Patients with CNS-based functional impairments with primary cancer
diagnoses (n = 107) and noncancer diagnoses (n = 480), admitted to the inpatient
rehabilitation unit between January 1, 2005 and April 1, 2012, who were aged 1 to
20 years at time of admission. INTERVENTION: Not applicable. MAIN OUTCOME
MEASURES: Pediatric Functional Independence Measure (WeeFIM) reflecting
functional status was collected at admission and discharge with change score and
WeeFIM efficiency calculated. Length of stay on the rehabilitation unit and
unplanned transfer rates were also collected. RESULTS: No significant difference
in total WeeFIM scores at admission was found between cancer and noncancer
groups. Both groups had significant increases in WeeFIM scores at discharge (P <
.001). The noncancer group had significantly higher WeeFIM change in self-care (P
= .001), mobility (P = .009), and total score (P = .004) and had a greater length
of stay (P < .001). A comparison of WeeFIM efficiency in all domains revealed no
significant difference between cancer and noncancer groups. There was also no
significant between-group difference in unplanned transfer rates. CONCLUSIONS:
Children with CNS-based functional impairments with cancer and noncancer
diagnoses made functional gains with similar WeeFIM efficiencies after undergoing
inpatient rehabilitation. However, patients with noncancer diagnoses made greater
gains in self care, mobility, and total scores with longer stays on the
rehabilitation service. No significant difference was found in unplanned transfer
rates between cancer and noncancer groups for acute medical care.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS