Why the study?
The LACE+ risk-prediction tool had never been tested in an orthopedic surgery population, where it may help identify and support high-risk patients following hospital discharge.
Does a higher LACE+ score predict 30-day readmission, ED visits, and reoperation in orthopedic surgery patients?
Does a higher LACE+ score predict 30-day readmission, ED visits, and reoperation in orthopedic surgery patients?
The LACE+ score effectively predicts 30-day readmission, ED visits, and reoperation risks in orthopedic surgery patients, aiding in identifying high-risk individuals for targeted support.
May support risk stratification for monitoring in orthopedic patients; extends LACE+ validation but leaves open impact of interventions.
The LACE+ (Length of stay, Acuity of admission, Charlson Comorbidity Index score, and Emergency department visits in the past 6 months) risk-prediction tool has never been tested in an orthopedic surgery population. LACE+ may help physicians more effectively identify and support high-risk orthopedics patients after hospital discharge. LACE+ scores were retrospectively calculated for all consecutive orthopedic surgery patients (n = 18 893) at a multi-center health system over 3 years (2016-2018). Coarsened exact matching was employed to create "matched" study groups with different LACE+ score quartiles (Q1, Q2, Q3, Q4). Outcomes were compared between quartiles. In all, 1444 patients were matched between Q1 and Q4 (n = 2888); 2079 patients between Q2 and Q4 (n = 4158); 3032 patients between Q3 and Q4 (n = 6064). Higher LACE+ scores significantly predicted 30D readmission risk for Q4 vs Q1 and Q4 vs Q3 (P < .001). Larger LACE+ scores also significantly predicted 30D risk of ED visits for Q4 vs Q1, Q4 vs Q2, and Q4 vs Q3 (P < .001). Increased LACE+ score also significantly predicted 30D risk of reoperation for Q4 vs Q1 (P = .018), Q4 vs Q2 (P < .001), and Q4 vs Q3 (P < .001).
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Caplan et al. (2020) studied this question.
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