title: Risk of not being discharged home after isolated coronary artery bypass graft operations.
abstract: BACKGROUND
  The age and risk profile of patients undergoing isolated coronary artery bypass grafting (CABG) is increasing, which will likely increase the proportion of CABG patients discharged to nursing homes, rehabilitation, or long-term care. Because discharge disposition can be important to a patient's treatment goals, developing and using predictive tools will improve informed treatment decision making. We examined the utility of The Society of Thoracic Surgeons (STS) risk of mortality score in predicting discharge disposition after CABG.
  
  
  METHODS
  From January 1, 2004 to October 31, 2011, 5,119 patients underwent isolated CABG at The Heart Hospital Baylor Plano or Baylor University Medical Center (Texas) and were discharged alive. The association between STS risk of mortality and discharge to nursing home, rehabilitation, or long-term care was assessed using multivariable logistic regression, adjusted for age, body surface area, marital status, site, and year of operation.
  
  
  RESULTS
  At discharge, 216 patients (4.21%) went to nursing homes, 153 (2.99%) to rehabilitation, and 115 (2.25%) to long-term care. The STS risk of mortality score was significantly positively associated with discharge status (p < 0.001). Patients with 1%, 2%, 3%, 4%, and 5% STS risk of mortality had 11.25%, 22.10%, 29.45%, 35.00%, and 38.50% probability, respectively, of not being discharged home. When the STS risk of mortality was 5%, the risk of not being discharged home was 47.9% for off-pump patients and 38.10% for on-pump patients.
  
  
  CONCLUSIONS
  STS risk score is strongly associated with CABG discharge status. Patients with a risk score exceeding 2 are at high risk (>22%) of not being discharged home. This risk should be discussed when treatment decisions are being made.
authors: The Heart Hospital Baylor Plano, Plano, Texas; Cardiopulmonary Research Science and Technology Institute, Medical City Dallas Hospital, Dallas, Texas.
authors: James
authors: J
authors: Edgerton
authors: The Heart Hospital Baylor Plano, Plano, Texas; Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, Texas; Department of Statistical Science, Southern Methodist University, Dallas, Texas; Department of Infectious Diseases, University of Louisville, Louisville, Kentucky; Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas. Electronic address: giovanfi@baylorhealth.edu.
authors: Giovanni
authors: G
authors: Filardo
authors: The Heart Hospital Baylor Plano, Plano, Texas; Cardiopulmonary Research Science and Technology Institute, Medical City Dallas Hospital, Dallas, Texas.
authors: William H
authors: WH
authors: Ryan
authors: The Heart Hospital Baylor Plano, Plano, Texas; Cardiopulmonary Research Science and Technology Institute, Medical City Dallas Hospital, Dallas, Texas.
authors: William T
authors: WT
authors: Brinkman
authors: The Heart Hospital Baylor Plano, Plano, Texas; Cardiopulmonary Research Science and Technology Institute, Medical City Dallas Hospital, Dallas, Texas.
authors: Robert L
authors: RL
authors: Smith
authors: The Heart Hospital Baylor Plano, Plano, Texas; Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas.
authors: Robert F
authors: RF
authors: Hebeler
authors: Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas.
authors: Baron
authors: B
authors: Hamman
authors: Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, Texas.
authors: Danielle M
authors: DM
authors: Sass
authors: Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, Texas.
authors: Jessica P
authors: JP
authors: Harbor
authors: The Heart Hospital Baylor Plano, Plano, Texas; Cardiopulmonary Research Science and Technology Institute, Medical City Dallas Hospital, Dallas, Texas.
authors: Michael J
authors: MJ
authors: Mack
mesh_terms: D001026:Coronary Artery Bypass / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012307:Risk Factors
keywords: 23