PMID- 36958648
OWN - NLM
STAT- MEDLINE
DCOM- 20230905
LR  - 20230905
IS  - 1532-821X (Electronic)
IS  - 0003-9993 (Linking)
VI  - 104
IP  - 9
DP  - 2023 Sep
TI  - Association Between Laboratory Values and Adverse Events in Adults 
      Post-Hematopoietic Stem Cell Transplant During and After Rehabilitation.
PG  - 1425-1431
LID - S0003-9993(23)00161-2 [pii]
LID - 10.1016/j.apmr.2023.03.002 [doi]
AB  - OBJECTIVE: The objective of this study was to examine the relationship between 
      adverse events (AEs) and critical events (CEs) during and after rehabilitation in 
      cancer patients post-hemopoietic stem cell transplant (HSCT) or bone marrow 
      transplant (BMT) and to identify whether particular laboratory values are 
      associated with increased risk of AEs or CEs. DESIGN: A retrospective chart 
      review (2012-2017) of hospitalized patients ages 18-75 years who received a 
      diagnosis of cancer and BMT or HSCT receiving rehabilitation services SETTING: 
      Urban Midwest tertiary, research and academic hospital. PARTICIPANTS: In total, 
      99 hospitalized adults with HSCT or BMT participated in 300 rehabilitation 
      sessions. INTERVENTIONS: Physical or occupational therapy using a symptom-based 
      approach in which patient symptoms were monitored and therapy was adjusted in 
      real time MAIN OUTCOME MEASURES: Incidence of AEs or CEs occurring during or 
      within 48 hours of rehabilitation. RESULTS: A total of 300 rehabilitation 
      sessions were carried out where 99.7% had 1 or more laboratory values outside 
      reference range. In only 3.3% of therapy sessions an AE occurred during or within 
      2 hours of rehabilitation. Within 48 hours postrehabilitation, AEs occurred in 
      22.3% and CEs in 4%. No laboratory value was significantly associated with 
      increased risk of AEs or CEs during rehabilitation. A hemoglobin <8.0 g/dL 
      conferred an increased risk of AEs (odds ratio [OR], 2.85-6.89) depending on 
      timeframe analyzed and overall risk of CE (OR, 3.75). Lower hemoglobin levels 
      (<7.5 g/dL and <7.0 g/dL) did not increase this risk. Low platelets (<25 k/muL) 
      increased the risk of AEs on day 1, 2 and overall (OR, 2.5-2.72) and overall risk 
      of CEs (OR, 6.62). CONCLUSIONS: Our research demonstrates a low rate of AEs and 
      CEs during or within 2 hours of rehabilitation but supports the need to monitor 
      patients when hemoglobin is <8 g/dL or platelets are <25 k/muL due to the 
      increased risk of events.
CI  - Copyright (c) 2023 American Congress of Rehabilitation Medicine. Published by 
      Elsevier Inc. All rights reserved.
FAU - Nielsen, Kelli A
AU  - Nielsen KA
AD  - Department of Physical Therapy, St Catherine University, St. Paul, MN; Department 
      of Rehabilitation Services, M Health Fairview, Minneapolis, MN. Electronic 
      address: kanielsen@stkate.edu.
FAU - George, Caroline L S
AU  - George CLS
AD  - Department of Pediatrics, Division of Pediatric Critical Care, University of 
      Minnesota, Minneapolis, MN.
FAU - Gilchrist, Laura S
AU  - Gilchrist LS
AD  - Department of Physical Therapy, St Catherine University, St. Paul, MN.
LA  - eng
PT  - Journal Article
DEP - 20230322
PL  - United States
TA  - Arch Phys Med Rehabil
JT  - Archives of physical medicine and rehabilitation
JID - 2985158R
RN  - 0 (Hemoglobins)
SB  - IM
MH  - Humans
MH  - Adult
MH  - Retrospective Studies
MH  - *Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Hemoglobins
OTO - NOTNLM
OT  - Hemoglobin
OT  - Rehabilitation
OT  - Thrombocytopenia
EDAT- 2023/03/24 06:00
MHDA- 2023/09/05 06:41
CRDT- 2023/03/23 20:32
PHST- 2022/06/27 00:00 [received]
PHST- 2023/02/02 00:00 [revised]
PHST- 2023/03/05 00:00 [accepted]
PHST- 2023/09/05 06:41 [medline]
PHST- 2023/03/24 06:00 [pubmed]
PHST- 2023/03/23 20:32 [entrez]
AID - S0003-9993(23)00161-2 [pii]
AID - 10.1016/j.apmr.2023.03.002 [doi]
PST - ppublish
SO  - Arch Phys Med Rehabil. 2023 Sep;104(9):1425-1431. doi: 
      10.1016/j.apmr.2023.03.002. Epub 2023 Mar 22.