The Predictive Value of the HOSPITAL Score and LACE Index for an Adult Neurosurgical Population: A Prospective Analysis
| Autor: | Gic-Owens Fiestan, Joseph J. Gemmete, Rachel Foshee, Venkatakrishna Rajajee, Kyle M. Sheehan, Joseph R Linzey, Aditya S. Pandey, James F. Burke, James M. Mossner, Sudharsan Srinivasan |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Multivariate statistics medicine.medical_specialty Time Factors Population Logistic regression Risk Assessment Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Prospective Studies education Aged education.field_of_study business.industry Medical record Odds ratio Middle Aged Hospitals Confidence interval Hospitalization 030220 oncology & carcinogenesis Female Surgery Neurology (clinical) Emergency Service Hospital Risk assessment business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | World Neurosurgery. 137:e166-e175 |
| ISSN: | 1878-8750 |
| Popis: | Objective The HOSPITAL score (HS) and LACE index (LI) are 2 validated methods for quantifying the risk of 30-day unplanned readmission after discharge. However, neither score has been validated in the neurosurgical population. This study evaluated the HS and LI in the neurosurgical population as effective predictors for 30-day unplanned readmission. Methods We performed a prospective, cohort analysis of all consecutive adult patients admitted to the neurosurgical service between October 1, 2018 and May 1, 2019. Patient medical records were used to calculate HS and LI. HS defined groups as low risk (0–4), intermediate (5–6), and high (7–12); LI defined risk as low (1–4), moderate (5–9), and high (10–19). Data analysis used univariate and multivariate logistic regressions. Results The 1242 patients included 626 women (50.4%). The average age was 57.9 years, and most patients (86.5%) underwent surgery during their admission. In multivariate logistic regression, intermediate-risk HS was not predictive of 30-day readmission (odds ratio [OR], 1.04; 95% confidence interval [CI], 0.57–1.88; P = 0.53), whereas high-risk HS did predict readmission (OR, 2.87; 95% CI, 1.49–5.54; P = 0.002). Likewise, moderate-risk LI was not predictive of 30-day unplanned readmission or mortality (OR, 1.59; 95% CI, 0.88–2.85; P = 0.12); however, high-risk LI did predict unplanned readmission or mortality (OR, 2.58; 95% CI, 1.16–5.73; P = 0.02). Both HS and LI showed poor to moderate discrimination (C = 0.62 and 0.60, respectively). Conclusions A high-risk HS and high-risk LI were predictive of 30-day unplanned readmission. Although neither score is ideal for predicting moderate risk for 30-day unplanned readmission in neurosurgical patients, both have some predictiveness that may be clinically valuable. |
| Databáze: | OpenAIRE |
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