Keywords

outcome prediction, readmissions, gynecologic surgery, LACE+ index, coarsened exact matching

 

Authors

  1. Glauser, Gregory
  2. Winter, Eric
  3. Caplan, Ian F.
  4. Goodrich, Stephen
  5. McClintock, Scott D.
  6. Srinivas, Sindhu K.
  7. Malhotra, Neil R.

ABSTRACT

Background: The LACE+ index is a well-studied metric that compacts patient data in an effort to assess readmission risk.

 

Purpose: Assess the capacity of LACE+ scores for predicting short-term undesirable outcomes in an entire single-center population of patients undergoing gynecologic surgery.

 

Importance and Relevance to Healthcare Quality: Proactive identification of high-risk patients, with tools such as the LACE+ index, may serve as the first step toward appropriately engaging resources for reducing readmissions.

 

Methods: This study was a retrospective analysis that used coarsened exact matching. All gynecologic surgery cases over 2 years within a single health system (n = 12,225) were included for analysis. Outcomes of interest were unplanned readmission, emergency room (ER) evaluation, and return to surgery. Composite LACE+ scores were separated into quartiles and matched. For outcome comparison, matched patients were assessed by LACE+ quartile, using Q4 as the reference group.

 

Results: Increasing LACE+ score reflected a higher rate of readmission (p = .003, p = .001) and visits to the ER at 30 postoperative days (p < .001).

 

Conclusion: The data presented here suggest that LACE+ index is a viable metric for patient outcome prediction following gynecologic surgery.