Pre-transplant Rehabilitation to Decrease the Post-transplant Length of Stay for Hematological Malignancy Patients Undergoing Allo-HSCT

Ryutaro Matsugaki; Makoto Ohtani; Yuko Mine; Satoru Saeki; Kiyohide Fushimi; Shinya Matsuda

doi:10.2490/prm.20210020

Pre-transplant Rehabilitation to Decrease the Post-transplant Length of Stay for Hematological Malignancy Patients Undergoing Allo-HSCT

Prog Rehabil Med. 2021 Apr 28:6:20210020. doi: 10.2490/prm.20210020. eCollection 2021.

Authors

Ryutaro Matsugaki¹, Makoto Ohtani², Yuko Mine¹, Satoru Saeki³, Kiyohide Fushimi⁴, Shinya Matsuda¹

Affiliations

¹ Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
² Information Systems Center for Occupational Health, University of Occupational and Environmental Health, Kitakyushu, Japan.
³ Department of Rehabilitation Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
⁴ Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.

Abstract

Objectives: Pre-transplant rehabilitation for hematological malignancy patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) helps improve physical capacity. However, its benefit with respect to post-transplant hospital length of stay (LOS) is unclear. Consequently, the aim of this study was to investigate the effect of pre-transplant rehabilitation on post-transplant LOS for hematological malignancy patients undergoing allo-HSCT.

Methods: Data on patients diagnosed between April 2014 and March 2017 were collected from the Japanese Diagnosis Procedure Combination database. The patients were identified using the ICD-10 codes C81-85, C90-94, C96, and D46. Multilevel linear regression analyses were conducted to identify the effects of pre-transplant rehabilitation on post-transplant LOS (log transformed).

Results: In total, 3614 patients were included in the study. Pre-transplant rehabilitation was associated with a significant reduction in post-transplant hospital LOS (β=-0.134, P<0.001).

Conclusions: Pre-transplant rehabilitation may be an effective strategy for shortening the post-transplant hospital LOS in hematological malignancy patients undergoing allo-HSCT. Consequently, it may be necessary to consider starting rehabilitation before transplantation.

Keywords: allogeneic hematopoietic stem cell transplantation; hematological malignancy; length of stay; pre-transplant rehabilitation.