Introduction: Prolonged bed rest is often associated with acute inpatient hospital admissions, has been shown to significantly decrease patient’s physical function and health related quality of life (HRQoL). The aim of this study was to investigate the effects of hospitalisation and to describe the pattern and prevalence of functional decline in oncology patients over the course of their inpatient admission.
Methods: This was a prospective observational study of 55 consenting inpatients recruited over a 10 week period. Assessment measures were undertaken bi-weekly until discharge from hospital or they became too unwell to continue. Functional status and HRQoL data were collected using the, timed up and go test (TUG), 30-second chair sit to stand (STS), 30-second arm curl, isometric muscle strength testing, EORTC-C30 and SF-8.
Results: 55 patients (28 male), median age 64 years (± SD 10.8) with an average length of stay of 18 days participated in the study. Reason for hospital admission included; symptom management (36%) or delivery of cancer treatment (35%). A number of subscales on the EORTC-C30 including physical functioning and functional assessments (TUG, STS and knee extension) showed a trend of weekly decline in performance but were not statistically significant. Compared to the general population 87% and 82% of the cohort scored below the norm in physical functioning and mental health respectively; 43% recorded TUG indicative of falls risks; 76% were below age matched norms for STS and 20% were below in upper limb strength.
Conclusion: Despite non-significant declines in physical functioning and HRQoL during their hospital admission, participants demonstrated substantially reduced HRQoL and physical functioning at time of hospital admission and at discharge compared to healthy age-matched normative data. Despite this low level of function very few received rehabilitation follow-up. Screening programs using simple functional assessment measures (STS, TUG) could be useful in identifying patients at risk of deconditioning and those who require specialised input on discharge to prevent further declines in function and hospital re-admissions.