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Association Between LACE+ Index Risk Category and 90-Day Mortality After Stroke.

Adalia Jun-O'Connell1, Brian Silver1, Eliza Grigoriciuc1

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Neurology. Clinical Practice
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PubMed
Summary
This summary is machine-generated.

The LACE+ index, calculated at admission and discharge, effectively identifies stroke patients at higher risk for 90-day mortality. This risk stratification tool can aid in developing early interventions to reduce post-stroke death rates.

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Area of Science:

  • Neurology
  • Public Health
  • Gerontology

Background:

  • The LACE+ index is typically used to predict readmissions and mortality post-discharge.
  • Its effectiveness in predicting mortality specifically after stroke remains unexamined.

Purpose of the Study:

  • To investigate the association between the LACE+ index risk category and 90-day post-stroke mortality.
  • To assess the utility of LACE+ scores calculated at both admission (aLACE+) and discharge (dLACE+).

Main Methods:

  • Retrospective analysis of 2,729 stroke patients (ischemic or hemorrhagic) from an institutional registry (2018-2021).
  • Patients were stratified into low-to-medium (0-58), medium-to-high (59-77), and high-risk (≥78) LACE+ categories.
  • Primary outcome was 90-day mortality, analyzed using Kaplan-Meier and Cox-regression models.

Main Results:

  • Overall 90-day mortality rate was 24.3% among patients with follow-up.
  • High-risk aLACE+ category showed significantly higher 90-day mortality (p < 0.001).
  • Adjusted Cox-regression revealed increased 90-day mortality hazards for high-risk (aHR 1.7) and medium-to-high-risk (aHR 1.4) aLACE+ categories; similar findings for dLACE+.

Conclusions:

  • The LACE+ index, assessed at admission and discharge, effectively identifies stroke patients at elevated risk for 90-day mortality.
  • Further research is needed to explore LACE+ score-based interventions for mitigating post-stroke mortality.