Functional Outcomes and Unplanned Transfers of Pediatric Patients With Central Neurological Impairments Receiving Inpatient Rehabilitation Care With Cancer and Noncancer Diagnoses

Background Functional impairments from central nervous system (CNS) dysfunction experienced by pediatric patients with cancer diagnoses are well documented. However, little is known of these patients' functional outcomes and potential complications while receiving inpatient rehabilitation services. Objective To compare functional outcomes and unplanned transfer rates of pediatric patients with impairments associated with CNS dysfunction between those with primary cancer diagnoses and noncancer diagnoses while receiving inpatient rehabilitation care. Design Retrospective comparison cohort study. Setting Inpatient rehabilitation unit within a regional tertiary care pediatric hospital. Participants Patients with CNS-based functional impairments with primary cancer diagnoses (n = 107) and noncancer diagnoses (n = 480), admitted to the inpatient rehabilitation unit between January 1, 2005 and April 1, 2012, who were aged 1 to 20 years at time of admission. Intervention Not applicable. Main Outcome Measures Pediatric Functional Independence Measure (WeeFIM) reflecting functional status was collected at admission and discharge with change score and WeeFIM efficiency calculated. Length of stay on the rehabilitation unit and unplanned transfer rates were also collected. Results No significant difference in total WeeFIM scores at admission was found between cancer and noncancer groups. Both groups had significant increases in WeeFIM scores at discharge (P < .001). The noncancer group had significantly higher WeeFIM change in self-care (P = .001), mobility (P = .009), and total score (P = .004) and had a greater length of stay (P < .001). A comparison of WeeFIM efficiency in all domains revealed no significant difference between cancer and noncancer groups. There was also no significant between-group difference in unplanned transfer rates. Conclusions Children with CNS-based functional impairments with cancer and noncancer diagnoses made functional gains with similar WeeFIM efficiencies after undergoing inpatient rehabilitation. However, patients with noncancer diagnoses made greater gains in self care, mobility, and total scores with longer stays on the rehabilitation service. No significant difference was found in unplanned transfer rates between cancer and noncancer groups for acute medical care.