Article

The aim of this study was to assess the frequency and reasons for
return to the primary acute care service among patients with leukemia undergoing
inpatient rehabilitation.
DESIGN: This is a retrospective study of all patients
with leukemia, myelodysplastic syndrome, aplastic anemia, or myelofibrosis
admitted to inpatient rehabilitation at a tertiary referral-based cancer center
between January 1, 2005, and April 10, 2012. Items analyzed from patient records
included return to the primary acute care service with demographic information,
leukemia characteristics, medications, hospital admission characteristics, and
laboratory values. RESULTS: Two hundred twenty-five patients were admitted a
total of 255 times. Ninety-three (37%) of the 255 leukemia inpatient
rehabilitation admissions returned to the primary acute care service. Eighteen
(19%) and 42 (45%) of the 93 patients died in the hospital and were discharged
home, respectively. Statistically significant factors (P < 0.05) associated with
return to the primary acute care service include peripheral blast percentage and
the presence of an antifungal agent on the day of the inpatient rehabilitation
transfer. Using additional two factors (platelet count and the presence of an
antiviral agent, both P < 0.11), the Return to Primary-Leukemia Index was
formulated. CONCLUSIONS: Patients with leukemia with the presence of circulating
peripheral blasts and/or an antifungal agent may be at increased risk for return
to the primary acute care service. The Return to Primary-Leukemia Index should be
tested in prospective studies to determine its usefulness.

Langue : ANGLAIS