Predicting Early Mortality in the Inpatient Cancer Rehabilitation Population Using Admission Performance Status Score.

Abstract

The aim of the study was to determine if a low admission Karnofsky Performance Scale score is indicative of a higher likelihood of death within 3 mos of discharge from inpatient rehabilitation with an active cancer diagnosis. A retrospective, observational design was employed to analyze electronic medical records of 385 patients with a primary or concurrent diagnosis of cancer admitted from a multicenter, acute inpatient rehabilitation hospital system between January 1, 2020, and December 31, 2020. Of the 385 patients, a total of 77 patients (20%) had an observed death within 3 mos. Out of the sample of patients with an observed death within a 15-mo window ( n = 157), 49% died within 3 mos of discharge from the IRF. Patients with a Karnofsky Performance Scale score of 40 or less had a significantly higher risk of mortality within 3 mos of discharge (hazard ratio = 1.49, 95% confidence interval = 1.09-2.04, P = 0.013). For those surviving less than 3 mos, average survival was 32 days. Improvements in Karnofsky Performance Scale score during the inpatient stay were linked to better survival outcomes. These findings provide insight into the prognosis of patients with cancer in inpatient rehabilitation, emphasizing the importance of functional assessment in predicting mortality within 3 mos of discharge.