Association between geriatric co-management and receipt of rehabilitation services in the inpatient postoperative period among older adults with cancer.

Abstract

Purpose: Geriatric co-management is associated with a lower postoperative mortality among older adults with cancer. This might be due to a higher use of rehabilitation services such as physical therapy (PT) or occupational therapy (OT). In this study, we assess the relationship between geriatric co-management and PT /OT use.

Methods: This is a retrospective cohort study of adults aged 75 years and older with cancer who underwent elective surgery at Memorial Sloan Kettering Cancer Center between February 2015 and February 2018. We used two separate multivariable logistic regression models for PT and OT, adjusted for age at surgery, gender, American Society of Anesthesiology score, preoperative albumin, operative time, and estimated blood loss. We also evaluated the association between frailty and receipt of PT and or OT using separate models by additionally including frailty as a primary predictor.

Results: Of the 1650 patients, 308 (19%) did not receive PT or OT, 747 (45%) received only PT, and 593 (36%) received both PT and OT. Geriatric co-management was significantly associated with higher PT use (OR = 1.58, 95% CI = 1.19, 2.11, p = 0.002) and higher OT use (OR = 1.36, 95% CI = 1.08, 1.71, p = 0.010). The associations between geriatric co-management and rehabilitation service remained after additional adjustment for frailty. Higher degree of frailty was also associated with higher PT use (OR = 1.11, 95% CI = 1.01, 1.22, p = 0.033) and higher OT use (OR = 1.25, 95% CI = 1.15, 1.34, p < 0.0001).

Conclusions: Geriatric co-management and frailty were associated with greater use of PT and OT. Future studies should investigate the impact of geriatric co-management on functional recovery.