Tang Min, Mawji Nadir, Chung Samantha, Brijlal Ryan, Lim Sze How Jonathan Ken, Wickerson Lisa, Rozenberg Dmitry, Singer Lianne G, Mathur Sunita, Janaudis-Ferreira Tania
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.
Clin Transplant. 2015 Jul;29(7):581-7. doi: 10.1111/ctr.12556. Epub 2015 May 16.
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.
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.
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.
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.
需要额外护理的肺移植（LT）受者在出院回家前可能会被转至住院康复机构。本研究旨在描述LT后的出院去向，比较出院至不同去向的患者特征，并确定出院去向的预测因素。
对2006年至2009年间存活至出院的243例LT受者进行回顾性研究。根据出院去向，对LT受者在人口统计学、临床特征和医疗保健利用方面的数据进行比较。
在这243例受者中，197例（81%）出院回家，42例（17%）转至住院康复机构，4例（2%）转至其他医疗机构。出院回家的患者与转至住院康复机构的患者在年龄、肺部诊断、移植前最近的六分钟步行距离（6MWD）、移植前机械通气、优先排队状态、移植前后重症监护病房住院时间（ICU LOS）、移植后住院时间、总住院时间以及是否参与移植前康复方面存在统计学差异。年龄、移植前最近的6MWD、移植前机械通气和总住院时间被发现是出院去向的独立预测因素。
临床因素有助于识别更可能需要住院康复的患者。识别这些因素有可能促进早期出院计划并优化护理的连续性。
