Frequency of venous thromboembolism events during acute inpatient rehabilitation in a comprehensive cancer centre
Amy H. Ng, Liat Goldman, Jack B. Fu, Thein H. Oo, Gary B. Chisholm, Diane D. Liu, Anuja Bedi, Eduardo Bruera
Department of Palliative Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, 77030 Houston, USA. E-mail: email@example.com
Objective: To determine the frequency of venous thromboembolism, possible predictors, and the association between venous thromboembolism and Functional Independence Measure (FIM) scores and length of stay among cancer patients admitted to the inpatient rehabilitation unit at a cancer centre.
Design: Retrospective analysis of patients admitted to acute inpatient rehabilitation from September 2011 to June 2013.
Subject/patients: Cancer patients in the acute inpatient rehabilitation unit within a tertiary cancer centre.
Methods: International Classification of Diseases (ICD-9) codes identified deep vein thrombosis, pulmonary embolism, and inferior vena cava filter.
Results: Venous thromboembolism occurred in 32/611 patients (5.2%): 23/611 (3.8%) during the course of hospitalization before admission to rehabilitation, and 9/611 patients (1.5%) during rehabilitation. Patients with lower extremity oedema at admission (p = 0.0218) had a higher chance of subsequently developing venous thromboembolism. Patients with venous thromboembolism during rehabilitation had a significantly lower FIM transfer score at admission to rehabilitation (p = 0.0247), a longer length of stay in rehabilitation (p = 0.0013) and overall hospitalization (p = 0.0580).
Conclusion: Cancer patients with low FIM transfer scores and lower extremity oedema are at higher risk of venous thromboembolism. Patients with these clinical findings at admission may require measures for more aggressive surveillance for the presence of venous thromboembolism. Patients with venous thromboembolism had an increased length of stay in rehabilitation, but ultimately did not have significant differences in FIM score changes.