LACE Index: Predicting Early Death or Hospital Readmission
Author: Canadian Medical Association Journal
Published: 1 Mar 2010 - Updated: 7 Nov 2022
Peer Reviewed Publication: Yes
Table of Contents:
Synopsis - Definition - Overview - Related Content
Synopsis
Physicians predict likelihood of death or readmission to hospital for patients within 30 days of discharge from hospital.
Topic Definition
- LACE Index
The LACE index for readmission predicts 30-day readmission or death in patients on medicine and surgery wards. The LACE index uses four variables to predict the risk of death or nonelective 30-day readmission after hospital discharge among both medical and surgical patients: length of stay (L), acuity of the admission (A), comorbidity of the patient (C) and emergency department use in 6 months before admission (E).
Overview
A new tool can help physicians predict the likelihood of death or readmission to hospital for patients within 30 days of discharge from hospital, according to a new study in CMAJ (Canadian Medical Association Journal)
The tool, called the LACE index, was developed by researchers at the Ottawa Hospital Research Institute, the Institute for Clinical Evaluation Sciences, the University of Toronto, the University of Ottawa, and the University of Calgary. It was developed to help quantify the risk of early death or unplanned readmission after discharge from the hospital to the community. It can be useful in focusing post-discharge support on patients at the highest risk of poor outcomes.
"We have derived and validated an easy-to-use index that is moderately discriminative and very accurate for predicting the risk of early death or unplanned readmission after discharge from hospital to the community," writes Dr. Carl Van Walraven, Ottawa Hospital Research Institute and coauthors.
The study followed 4812 patients admitted to 11 Ontario hospitals between October 2002 and July 2006. The participants were middle-aged, almost 95% were independent in daily living routines, and most were free of comorbidities. None of the participants were residents of nursing homes. The most common reasons for hospitalization were acute coronary syndromes, cancer diagnoses, complications, and heart failure.
During the first 30 days after discharge from the hospital, 8% (385) patients died or were urgently readmitted. Of this number, 9.4% (36) died, and 90.4% (349) had unplanned readmissions.
Key factors associated with these events were:
- L - Length of stay
- A - Acuity of admission
- C - Patient comorbidity
- E - Number of visits to the emergency room
Called the LACE index for easy recall, the index has a possible score of 0 to 19. While easy to use, the system will be difficult to memorize and will need a computational aid.
"We believe that clinicians can use the LACE index, researchers, and administrators to predict the risk of early death or unplanned readmission of cognitively intact medical or surgical patients after discharge from the hospital to the community," they conclude.
Further research is needed to determine if identifying the risk of poor death or readmissions changes patient care or outcomes.
Related Information
Attribution/Source(s): This peer-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally issued as a press release by Canadian Medical Association Journal and published on 1 Mar 2010. Last updated on 7 Nov 2022. This content may have been edited for style, clarity, or brevity.