Assessing the associations of early physical and occupational therapy on outcomes in patients admitted for hematopoietic stem cell transplant via cohort study.

INTRODUCTION

Patients undergoing hematopoietic stem cell transplant (HSCT) for hematologic cancers experience deconditioning postprocedure. Prehabilitation for patients admitted for HSCT improves fitness and has the potential to improve other outcomes as well.

OBJECTIVE

To investigate the associations of early physical and occupational therapy with outcomes for patients admitted for HSCT.

METHODS

Patients admitted for HSCT at the University of North Carolina between 2021 and 2023 were eligible for inclusion in this study. This chart-review study analyzed a quality improvement initiative started in 2022 to proactively consult physical and occupational therapy (PT/OT) at the time of admission for HSCT with the intent to improve patient outcomes, including reduced 30- and 90-day admissions, length of stay, complications, and improved survival and discharge disposition.

RESULTS

There were 206 patients in the proactive cohort and 206 patients in the no‑consult cohort included for analysis. Early physical and occupational therapy consultation at the time of admission for HSCT did not reduce 30- or 90-day readmissions, length of stay, 90-day survival, and no differences in discharge disposition compared to the no‑consult group. Patients who underwent autoHSCT in the proactive group had a higher 30-day admission rate (13% vs 5%, p = .02) and a higher total number of complications (6 vs 5, p = .004) than the no‑consult group.

CONCLUSION

The broader literature regarding prehabilitation of patients awaiting HSCT suggests that prehabilitation is important, and future study is needed to examine the ideal timing for therapy prior to admission for transplant to determine its influence on outcomes beyond functional status.