Predictors and variation of routine home discharge in critically ill adults with cystic fibrosis

Background: The short-term outcomes of patients with cystic fibrosis (CF) surviving critical illness were not examined systematically.

Objectives: To determine the factors associated with and variation in rates of routine home discharge among ICU-managed adult CF patients.

Methods: Predictors of routine home discharge and its hospital-level variation were examined in ICU-managed adults with cystic fibrosis in Texas during 2004-2013.

Results: Older age, rural residence, and severity of illness decreased odds of routine home discharge, while hospitalization in facilities accredited as part of the Cystic Fibrosis Foundation Care Center Network nearly doubled the odds of routine home discharge. The median (interquartile) adjusted rate of routine home discharge was 62.0% (31.5-82.5).

Conclusions: The identified determinants of routine home discharge can inform clinical decision-making, while the demonstrated wide variation in adjusted across-hospital rates of routine home discharge of ICU-managed adults with CF can provide benchmark data for future quality improvement efforts.