LACE index predicts age-specific unplanned readmissions and mortality after hospital discharge

Erica Heppleston, Christopher H Fry, Kevin Kelly, Beth Shepherd, Ria Wright, Gareth Jones, Jonathan Robin, Paul Murray, David Fluck, Thang S Han*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Background: The LACE index scoring tool (Length of stay, Acuity of admission, Co-morbidities and Emergency department visits) has been designed to predict hospital readmissions. We evaluated the ability of the LACE index to predict age-specific frequent admissions and mortality.
Methods: Analysis of prospectively collected data of alive-discharge episodes between 01/04/2017 and 31/03/2019 in an NHS hospital. Data on 14878 men and 17392 women of mean age 64.0 years, SD=20.5, range 18.0-106.7 years were analysed. The association of the LACE index with frequency of all-cause readmissions within 28 days of discharge and over a 2-year period, and with all-cause mortality within 30 days or within 6 months after discharge from hospital were evaluated.
Results: Within LACE index scores of 0-4, 5-9 or ≥10, the proportions of readmission ≥2 times within 28 days of discharge were 0.1, 1.3 and 9.2% (c2=3070, p<0.001) and over a 2-year period were 1.7, 4.8 and 19.1% (c2=3364, p<0.001). Compared with a LACE index score of 0-4, a score ≥10 increased the risk (adjusted for age, sex and frequency of admissions) of death within 6 months of discharge by 6.8-fold (5.1-9.0, p<0.001) among all ages, and most strongly in youngest individuals (18.0-49.9 years): adjusted odds ratio =16.1 (5.7-45.8, p<0.001). For those aged 50-59.9, 60-69.9, 70-79.9 and ≥80 years, odds ratios reduced progressively to 9.6, 7.7, 5.1 and 2.3, respectively. Similar patterns were observed for the association of LACE index with mortality within 30 days of hospital discharge.
Conclusions: The LACE index predicts short-term and long-term frequent admissions and short-term and medium-term mortality, most pronounced among younger individuals, after hospital discharge.
Original languageEnglish
Number of pages8
JournalAging Clinical and Experimental Research
DOIs
Publication statusPublished - 5 Jun 2020

Keywords

  • Prevention
  • Screening
  • Health economics
  • Quality of Care
  • Patient Safety

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