Key result
LACE index shows moderate capacity to predict 30-day unplanned readmissions after AMI.
Why the study?
Improving outcomes after AMI may be facilitated by identifying high-risk patients before discharge, prompting evaluation of the LACE index score for predicting 30-day all-cause mortality and readmission in South Australian AMI patients who had an angiogram.
Does the LACE index score accurately predict 30-day all-cause mortality and readmission in AMI patients who had an angiogram?
Cohort
Yes
Does the LACE index score accurately predict 30-day all-cause mortality and readmission in AMI patients who had an angiogram?
The LACE index provides moderate discriminatory capacity (C-statistic 0.62) for predicting 30-day readmissions and mortality in AMI patients post-angiogram.
Answers are grounded in this paper and cite their sources.
LACE index should not yet guide readmission risk stratification post-AMI; leaves open need for AMI-specific models with improved discrimination.
INTRODUCTION: Improving patient outcomes after acute myocardial infarction (AMI) may be facilitated by identifying patients at a high risk of adverse events before hospital discharge. We aimed to determine the accuracy of the LACE (Length of stay, Acuity, Comorbidities, Emergency presentations within prior 6 months) index score (a prediction tool) for predicting 30-day all-cause mortality and readmission rates (independently and combined) in South Australian AMI patients who had an angiogram. METHODS: All consecutive AMI patients enrolled in the Coronary Angiogram Database of South Australia Registry at two major tertiary hospitals and discharged alive between July 2016 to June 2017. A LACE score was calculated for each patient, and receiver operating characteristic curve analysis was performed. RESULTS: Analysis of registry patients found a 30-day unplanned readmission rate of 11.8% and mortality rate of 0.7%. Moreover, the LACE index was a moderate predictor (C-statistic = 0.62) of readmissions in this cohort, and a score ≥10 indicated moderate discriminatory capacity to predict 30-day readmissions. CONCLUSION: The LACE index shows moderate discriminatory capacity to predict 30-day readmissions and mortality. A cut-off score of nine to optimize sensitivity may assist clinicians in identifying patients at a high risk of adverse outcomes.
No takes yet. Share an insight, caveat, or question.
Labrosciano et al. (2021) conducted a cohort in Acute Myocardial Infarction. LACE index score was evaluated on 30-day all-cause mortality and readmission rates (C-statistic 0.62). The LACE index demonstrated moderate discriminatory capacity (C-statistic = 0.62) for predicting 30-day unplanned readmissions in patients with acute myocardial infarction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: