Readmission and Mortality in Trauma Patients Utilizing LACE Index

Area of Science:

• Trauma Surgery
• Healthcare Management
• Patient Outcomes

Background:

• Trauma patient readmissions pose a significant challenge post-discharge.
• The LACE Index (Length of stay, Acuity of admission, Comorbidity, Emergency department visits) predicts 30-day death or readmission.
• Early follow-up for high-risk trauma patients is a strategy to mitigate adverse outcomes.

Purpose of the Study:

• To identify factors associated with trauma patient readmission and mortality.
• To evaluate the impact of LACE Index-guided follow-up appointments on 30-day readmission and mortality rates.
• To test the hypothesis that LACE follow-ups reduce readmissions and mortality.

Main Methods:

• Retrospective review of trauma patients (≥18 years) before and during LACE follow-up implementation.
• Inclusion of 1788 patients across two periods: 872 before LACE (BL) and 914 during LACE (DL).
• Univariate and multivariable analyses to assess readmission and mortality risk factors and the impact of follow-up.

Main Results:

• Readmission rates were slightly higher during the LACE period (DL) compared to before (BL).
• Mortality rates were lower during the DL period compared to BL.
• Multivariable analysis identified cirrhosis as a risk factor for readmission and commercial insurance as a protective factor. Attending follow-up decreased mortality risk but not readmission risk.

Conclusions:

• Attending LACE follow-up appointments significantly decreased 30-day mortality in trauma patients.
• LACE follow-up did not significantly reduce 30-day readmission rates in this study.
• Further research is required to refine LACE score thresholds for preventing both readmission and mortality in trauma populations.