Functional status at ICU discharge is a predictor of discharge destination in elderly patients requiring prolonged intensive care after cardiac surgery

Abstract

Objective: The aim of this study was to identify the relationship between functional status at ICU discharge and discharge destination in elderly patients requiring prolonged ICU stay after cardiac surgery. Methods: A total of 278 patients aged 65 years or above (75±6 years, female 42%) who stayed in ICU for 3 days or longer after elective cardiac surgery were enrolled. Patients were divided into two groups according to the discharge destination; discharge to home (n=245) and transfer to other facility or hospital (n=33). We assessed the clinical characteristics as well as functional status using the functional status score for the ICU (FSS-ICU). The association between FSS-ICU and discharge destination was evaluated by logistic regression analysis. Receiver operating characteristics (ROC) curve analysis was used to calculate the optimal cutoff value of FSS-ICU for home discharge. Results: Multivariate logistic regression analysis identified age, operation time, and FSS-ICU score at ICU discharge as predictors of home discharge. The cut-off FSS-ICU score predicting home discharge was 21 points as determined by ROC curve. Conclusion: Functional status at ICU discharge assessed by FSS-ICU is an independent predictor of discharge destination in elderly patients who require prolonged ICU stay after cardiac surgery.