LAUSR

OBJECTIVE The objective of this study was to determine the ability of the AM-PAC"6-Clicks" Basic Mobility Short Form to predict patient discharge destination (home vs postacute care facility) from the cardiac intensive care unit (ICU), including patients from the cardiothoracic surgical ICU (CTS-ICU) and coronary care unit (CCU). METHODS This retrospective cohort study utilized electronic medical records of patients in cardiac ICU (n = 359) in an academic teaching hospital in the southeastern region of United States from September 1, 2017, through August 31, 2018. RESULTS The median interquartile range (IQR) age of the sample was 68 (75-60), 55% were men, median IQR "6-Clicks" score was 16 (20-12) at physical therapist evaluation, and 79% of the patients were discharged to home. Higher score on "6-Clicks" indicates improved function. A prediction model was constructed based on a machine learning approach using a classification tree. The classification tree was constructed and evaluated by dividing the sample into a train-test split using the Leave-One-Out cross-validation approach. The classification tree split the data into 4 distinct groups along with their predicted outcomes. Patients with a "6-Clicks" score > 15.5 and a "6-Clicks" score between 11.5 and 15.5 with primary insurance other than Medicare were discharged to home. Patients with a "6-Clicks" score between 11.5 and 15.5 with Medicare insurance and those with 6-Clicks score ≤ 11.5 were discharged to a postacute care facility. CONCLUSIONS Patients with lower "6-Clicks" scores were more likely to be discharged to a postacute care facility. Patients without Medicare insurance had to be significantly lower functioning indicated by lower "6-Clicks" scores for postacute care facility placement than those with Medicare insurance. IMPACT The ability of "6-Clicks" along with primary insurance to determine discharge destination allows for early discharge planning from cardiac ICUs.