Patients identified as high-risk by a LACE-rt score of 10 or higher were 2.65 times more likely to experience an unplanned 30-day hospital readmission compared to low-risk patients.
Observational (n=3,855)
No
Does the modified LACE index (LACE-rt) predict 30-day unplanned hospital readmission in general medicine patients?
The modified LACE-rt index is a fair tool for predicting 30-day unplanned readmission risk in a real-time community hospital setting, though its implementation alone did not reduce readmission rates.
Estimación del efecto: OR 2.648
Tasa de eventos absoluta: 23.9% vs 10.6%
valor p: p=<0.001
BACKGROUND: The LACE index was designed to predict early death or unplanned readmission after discharge from hospital to the community. However, implementing the LACE tool in real time in a teaching hospital required practical unavoidable modifications. OBJECTIVE: The purpose of this study was to validate the implementation of a modified LACE index (LACE-rt) and test its ability to predict readmission risk using data in a hospital setting. METHODS: Data from the Canadian Institute for Health Information's Discharge Abstract Database (DAD), the National Ambulatory Care Reporting System (NACRS), and the hospital electronic medical record for one large community hospital in Toronto, Canada, were used in this study. A total of 3855 admissions from September 2013 to July 2014 were analyzed (N=3855) using descriptive statistics, regression analysis, and receiver operating characteristic analysis. Prospectively collected data from DAD and NACRS were linked to inpatient data. RESULTS: The LACE-rt index was a fair test to predict readmission risk (C statistic=.632). A LACE-rt score of 10 is a good threshold to differentiate between patients with low and high readmission risk; the high-risk patients are 2.648 times more likely to be readmitted than those at low risk. The introduction of LACE-rt had no significant impact on readmission reduction. CONCLUSIONS: The LACE-rt is a fair tool for identifying those at risk of readmission. A collaborative cross-sectoral effort that includes those in charge of providing community-based care is needed to reduce readmission rates. An eHealth solution could play a major role in streamlining this collaboration.
Morr et al. (Wed,) conducted a observational in Unplanned hospital readmission (n=3,855). LACE-rt score ≥10 (High risk) vs. LACE-rt score <10 (Low risk) was evaluated on Unplanned hospital readmission within 30 days (OR 2.648, p=<0.001). Patients identified as high-risk by a LACE-rt score of 10 or higher were 2.65 times more likely to experience an unplanned 30-day hospital readmission compared to low-risk patients.