Aims
Increased cancer survival has led to a growing population of geriatric patients with cancer. The post-acute rehabilitation outcomes of these patients are poorly understood. This study aimed to investigate whether cancer status is associated with functional outcomes, new institutionalisation, and mortality in Australian Geriatric Evaluation and Management (GEM) patients.
Methods
Data from the observational longitudinal REStORing health of acutely unwell adulTs cohort was used. Patients were allocated to “no”, “past” and “active” cancer groups. Function was measured at GEM admission and discharge using Katz Activities of Daily Living (ADL) and Lawton-Brody Instrumental ADL (iADL) scores. Logistic regression and cox regression was performed to investigate the association between functional change with new institutionalisation and one-year mortality respectively.
Results
Of 1890 patients, 77.7% had “no”, 13.3% had “past”, and 9.0% had “active” cancer. ADL and iADL scores improved in all groups, with no significant difference between groups in functional outcomes or new institutionalisation. Compared to “no” cancer (2.9%), significantly higher proportion of “active” (8.2%) and “past” (6.0%) cancer patients died during the hospital admission, p<0.001. Active cancer was associated with higher three-and-12-month mortality. ADL and iADL improvement were significantly associated with reduced risk of 12-month mortality in “no” and “active” groups, and lower incidence of institutionalisation in all groups.
Conclusions
Despite higher mortality in active cancer patients, they can achieve similar functional gains after GEM and discharge back to the community. This may reflect careful patient selection for GEM. Functional improvement is of prognostic value in those with active cancer.