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

Objective: To determine if a low admission Karnofsky Performance Scale (KPS) score is indicative of a higher likelihood of death within three months of discharge from inpatient rehabilitation with an active cancer diagnosis.

Design: 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 multi-center, acute inpatient rehabilitation hospital system between January 1, 2020, and December 31, 2020.

Results: Of the 385 patients, a total of 77 patients (20%) had an observed death within 3 months. Out of the sample of patients with an observed death within a 15-month window (n = 157), 49% died within 3 months of discharge from the IRF. Patients with a KPS score of 40 or less had a significantly higher risk of mortality within three months of discharge (Hazard ratio = 1.49, 95% CI 1.09-2.04, p = 0.013). For those surviving less than three months, average survival was 32 days. Improvements in KPS score during the inpatient stay were linked to better survival outcomes.

Conclusion: These findings provide insight into the prognosis of patients with cancer in inpatient rehabilitation, emphasizing the importance of functional assessment in predicting mortality within three months of discharge.