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  4. Factors Associated with Discharge Destination in Patients with Bone Metastases

Factors Associated with Discharge Destination in Patients with Bone Metastases

Medicina, 2024 · DOI: 10.3390/medicina60060881 · Published: May 27, 2024

OncologyRehabilitation

Simple Explanation

This study looks at what factors influence where patients with bone metastases go after being discharged from the hospital. Understanding these factors can help improve their quality of life. The study found that spinal cord compression, hypercalcemia, and a patient's walking ability when admitted to the hospital are all connected to where they go after discharge. The ability to walk, specifically needing only one person to help prevent falls on level ground, was a key factor in being able to go home after hospitalization for bone metastases.

Study Duration
April 2015 and March 2020
Participants
278 patients diagnosed with bone metastases
Evidence Level
Retrospective, observational study

Key Findings

  • 1
    Spinal cord compression (SCC) was significantly associated with discharge to a non-home setting (OR 3.37, 95% CI 1.35–8.43).
  • 2
    Hypercalcemia was significantly associated with discharge to a non-home setting (OR 6.84, 95% CI 1.09–42.76).
  • 3
    Functional ambulation category (FAC) at admission was significantly associated with discharge destination (OR 0.45, 95% CI 0.35–0.58), with a cut-off value of 1.5 for predicting discharge to home.

Research Summary

This study aimed to identify factors associated with the discharge destination of patients with bone metastases, finding that spinal cord compression (SCC), hypercalcemia, and functional ambulation categories (FAC) at admission were significant factors. The study included 278 patients diagnosed with bone metastases and found that the cut-off value for admission FAC was 1.5, suggesting the importance of gait ability assessment on admission. The findings highlight the importance of early assessment of walking ability in patients with bone metastases for multidisciplinary collaboration to improve patient outcomes and determine appropriate discharge destinations.

Practical Implications

Early Gait Assessment

Assess patient's walking ability upon admission to predict discharge destination and tailor interventions.

Multidisciplinary Approach

Implement a multidisciplinary team approach for patients with bone metastases to address various factors influencing discharge destination.

Targeted Rehabilitation

Provide targeted rehabilitation interventions to improve functional ambulation categories (FAC) scores, potentially increasing the likelihood of discharge to home.

Study Limitations

  • 1
    Diverse range of cancer types within the study population
  • 2
    Variation in the time since the diagnosis of bone metastasis
  • 3
    Lack of standardized rehabilitation content

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