Composite Score for Outcome Prediction in Gynecologic Surgery Patients

J Healthc Qual. 2021 May-Jun;43(3):163-173. doi: 10.1097/JHQ.0000000000000254.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Emergency Service, Hospital*
  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Length of Stay
  • Patient Readmission*
  • Retrospective Studies
  • Risk Factors