Factors affecting discharge destination following lung transplantation.
BACKGROUND
Lung transplant (LT) recipients requiring additional care may be referred to inpatient rehabilitation prior to discharge home. This study seeks to describe discharge destinations following LT, compare the characteristics of patients discharged to different destinations, and identify the predictors of discharge destination.


METHODS
Retrospective study of 243 LT recipients who survived to hospital discharge between 2006 and 2009. LT recipients were compared based on discharge destination on data pertaining to demographics, clinical characteristics, and healthcare utilization.


RESULTS
Of the 243 recipients, 197 (81%) were discharged home, 42 (17%) to inpatient rehabilitation, and 4 (2%) to other medical facilities. Age, pulmonary diagnosis, most recent six-minute walk distance (6 MWD) prior to transplant, pre-transplant mechanical ventilation, priority listing status, pre- and post-transplant intensive care unit length of stay (ICU LOS), post-transplant LOS, total LOS, and participation in pre-transplant rehabilitation were statistically different between patients that were discharged home versus inpatient rehabilitation. Age, most recent 6 MWD prior to transplant, pre-transplant mechanical ventilation, and total LOS were found to be independent predictors of discharge destination.


CONCLUSIONS
Clinical factors can help identify patients more likely to require inpatient rehabilitation. Identification of these factors has the potential to facilitate early discharge planning and optimize continuity of care.
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Min
M
Tang
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Nadir
N
Mawji
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Samantha
S
Chung
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Ryan
R
Brijlal
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Jonathan Ken
JK
Lim Sze How
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.|Lung Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Lisa
L
Wickerson
Lung Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.|Department of Medicine, Division of Respirology, University of Toronto, Toronto, ON, Canada.
Dmitry
D
Rozenberg
Lung Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.|Department of Medicine, Division of Respirology, University of Toronto, Toronto, ON, Canada.
Lianne G
http://orcid.org/0000-0002-2693-8676
LG
Singer
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.|Respiratory Medicine, West Park Health Centre, Toronto, ON, Canada.
Sunita
S
Mathur
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.|Respiratory Medicine, West Park Health Centre, Toronto, ON, Canada.
Tania
T
Janaudis-Ferreira
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units; D007902:Length of Stay; D008171:Lung Diseases / Q000601:surgery*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012720:Severity of Illness Index
discharge planning; lung transplantation; rehabilitation