Impact of functional capacity before hematopoietic stem cell transplantation on the length of hospital stay

Abstract

Objective: To verify the association between pre-HSCT functional capacity and the variables of pulmonary function, fatigue and length of hospital stay. Methods: This is a cohort study, involving patients admitted to the Bone Marrow Transplantation. The individuals were submitted to an evaluation in the first 24 hours of hospitalization. The length of stay variable was checked on the day of hospital discharge. Functional capacity was assessed through the 6MWT, the 30-second sit-to-stand test (TSL30) was performed to assess the indirect strength of the lower limbs, moreover was used Revised Piper Fatigue Scale and evaluation of the pulmonary function. Results: The sample consisted of thirty-five individuals (19 male; 54%). Fourteen patients achieved a 6MWT ≥80% predicted. The mean age of the sample was 45.5 ± 15.2 years, and BMI 27.4 ± 5.4 kg/m². Patients who completed a 6MWD below the predicted value showed significantly lower pulmonary function values for the variables PEF(%) (p=0.031), FEV1 (%) (p=0.033) and FEV1/FVC(%) (p=0.027) in relation to the group with better functional capacity. This group showed significantly higher values in the assessment of lower limb fatigue using the Borg scale pre (p=0.008) and post (p=0.004) 6MWT, longer hospitalization time (p=0.0014), but with no significant difference in lower limb muscle strength between groups (p=0.21). A moderate correlation was found between the 6MWD% and FEV1% (p<0.05). Conclusion: Data indicate that starting HSCT treatment with lower-than-expected physical fitness is associated with lower lung function, greater fatigue in the lower limbs, and longer hospital stays.