Impact of lung transplantation on site of death in cystic fibrosis

BackgroundCystic fibrosis (CF) remains a lethal condition where a palliative approach is often taken at the end of life. We wanted to evaluate how lung transplantation impacts end of life care in adult CF patients.MethodsData were abstracted using a standardized data collection instrument from all outpatient and inpatient records of adult CF patients with an FEV1 ≤ 30% or prior lung transplantation followed at our Center. Comparisons were made between those who were listed/received lung transplant and those who were not listed.ResultsA total of 41 patients met the entry criteria. Of these, 63% (n = 26) were referred for lung transplant evaluation and 39% (n = 16) had undergone lung transplantation. Of these 41, 59% (n = 24) are deceased. The majority of deceased patients expired in an acute care hospital (63%, n = 15). There was no difference in site of death between the two groups (hospital versus home). However, listed/transplanted patients were more likely to die in an intensive care unit setting compared to patients not listed/transplanted (p = .013).ConclusionsMost of our CF patients' deaths occurred in an acute care hospital. Lung transplant significantly alters site of death and shifts it from medical floors to the intensive care unit.