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LACE+ Index as Predictor of 30-Day Readmission in Brain Tumor Population

Ian F Caplan1, Patricia Zadnik Sullivan1, David Kung1

  • 1Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

World Neurosurgery
|March 31, 2019
PubMed

Insights

The LACE+ index does not accurately predict 30-day readmissions for brain tumor surgery patients. Further research is needed to develop better predictive models for this specific population.

Area of Science:

  • Neurosurgery
  • Oncology
  • Health Services Research

Background:

  • The LACE+ index (Length of stay, Acuity of admission, Charlson Comorbidity Index score, and Emergency department visits) is a tool for predicting 30-day hospital readmissions.
  • Its utility in predicting readmissions for patients undergoing brain tumor surgery has not been established.

Purpose of the Study:

  • To evaluate the predictive accuracy of the LACE+ index for 30-day readmissions in patients who underwent craniotomy for supratentorial neoplasms.
  • To assess the LACE+ index's ability to predict reoperation and emergency department visits within 30 days post-surgery.

Main Methods:

  • Retrospective analysis of 352 patients undergoing craniotomy for supratentorial neoplasm.
  • Logistic regression and receiver operating characteristic (ROC) curve analysis were used to assess the LACE+ index's predictive performance.
  • Outcomes included 30-day readmission, reoperation, and emergency department visits.

Main Results:

  • A 1-unit increase in LACE+ score was associated with a 1.02 times increased odds of 30-day readmission (P=0.031).
  • However, the LACE+ index demonstrated poor specificity for predicting 30-day readmission (C-statistic=0.58).
  • The index did not significantly predict 30-day reoperation or emergency department visits.

Conclusions:

  • The LACE+ index is not a suitable prediction model for 30-day readmissions in the brain tumor surgery population.
  • The current predictive capabilities of the LACE+ index are insufficient for this specific patient group.
Abstract

Keywords:
Brain tumorsDischarge predictive toolHospital readmissionsLACE+ index

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