Risk for Non-home Discharge Following Surgery for Ischemic Mitral Valve Disease

Abstract Objectives To determine the frequency and risk factors for non-home discharge (NHD) and its association with clinical outcomes and quality of life (QOL) at 1 year following cardiac surgery in patients with ischemic mitral regurgitation (IMR). Methods Discharge disposition was evaluated in 552 patients enrolled in trials of severe or moderate IMR. Patient and in-hospital factors associated with NHD were identified using logistic regression. Subsequently, association of NHD with 1-year mortality, serious adverse events (SAE), and QOL was assessed. Results NHD was observed in 30% (154/522) with 25% (n=71/289) in moderate and 36% (n=83/233) in severe IMR patients (unadjusted p=0.006), a difference not significant after including age (5-year change: adjusted odds ratio [adjOR] 1.52; 95% confidence interval [CI] 1.35-1.72; p Conclusions NHD is common following surgery for IMR influenced by older age, diabetes, prior HF, and post-operative SAEs. These patients may be at higher risk of death and subsequent SAEs after discharge. Discussion of NHD with patients may have important implications for decision-making and guiding expectations following cardiac surgery.