PREOPERATIVE 6-MINUTE WALK DISTANCE AND DISCHARGE DISPOSITION IN LUNG TRANSPLANT PATIENTS

Abstract

SESSION TITLE: Transplantation SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: Preoperative lung transplantation evaluation routinely includes six minute walk distance (6MWD) and this is a component of the Lung Allocation Score. 6MWD has been shown to be associated with post-transplant survival. However, it is not known if pre-transplant 6MWD correlates with other post-transplant outcome measures. Our goal was to evaluate if there is a correlation between pre-lung transplant 6MWD and post-transplant discharge disposition. Our secondary aim was to evaluate if 6MWD correlated with 30 and 60 day readmission rate, ICU length of stay (LOS), hospital LOS and time on mechanical ventilation post-lung transplantation. METHODS: We conducted a single-center retrospective analysis of all lung transplanted patients from January 2014 to July 2017. Subjects were excluded if they had undergone multi-organ transplantation or re-transplantation. 6MWD was compared between patients discharged home and those discharged to inpatient rehabilitation (IPR) using logistic regression. 6MWD in patients readmitted at 30 and 60 days was compared to those not readmitted using linear regression. ICU LOS, hospital LOS and ventilator days were compared between patients with 6MWD >/= 200 and < 200 meters (m). RESULTS: We identified a total of 80 patients. There were 24 patients discharged to IPR, 50 to home and 6 died during hospitalization. Patients discharged to IPR had a lower mean 6MWD compared to those discharged to home (106 vs 200 m respectively, p = 0.005). 6MWD was significantly decreased in those patients readmitted within 30 days (146 vs 194 m, p = 0.09) and 60 days (144 vs 200 m, p = 0.05). In addition, patients with 6MWD less than 200 m had significantly longer ICU LOS (17.6 vs 32.7 days, p = 0.03), hospital LOS (26.7 vs 44.1 days, p = 0.01) and and time on mechanical ventilation (5.7 vs 19.2 days, p = 0.08). CONCLUSIONS: Transplanted patients with shorter preoperative 6MWD distance had longer ICU and hospital LOS as well as a higher likelihood of being discharged to IPR rather than home. Lower 6MWD was also associated with 30 and 60 day readmissions. This suggests that 6MWD may not only be associated with survival but also predict other post-transplant outcomes. CLINICAL IMPLICATIONS: Prospective lung transplant patients may be able to be counseled about expected postoperative outcomes and course based on their preoperative six minute walk distance. DISCLOSURES: No relevant relationships by Lisa Allenspach, source=Web Response No relevant relationships by Kaitlin Hanlon, source=Web Response No relevant relationships by Jeffrey Jennings, source=Web Response No relevant relationships by Hassan Nemeh, source=Web Response No relevant relationships by Julio Cesar Pinto Corrales, source=Web Response No relevant relationships by Lisa Stagner, source=Web Response