The LACE+ Index as a Predictor of 30-Day Patient Outcomes in a Plastic Surgery Population: A Coarsened Exact Match Study
| Autor: | Gregory Glauser, Neil R. Malhotra, Joshua Fosnot, Stephen J. Kovach, Stephen Goodrich, Joseph M. Serletti, Ian F. Caplan, Scott D. McClintock, Eric Winter |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Index (economics) Population Comorbidity 030230 surgery Patient Readmission 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans In patient education Aged Retrospective Studies Exact match Aged 80 and over education.field_of_study business.industry Emergency department Length of Stay Middle Aged Plastic Surgery Procedures Hospitalization Plastic surgery Treatment Outcome 030220 oncology & carcinogenesis Female Surgery Emergency Service Hospital business Body mass index Forecasting Quarter (Canadian coin) |
| Zdroj: | Plastic & Reconstructive Surgery. 146:296e-305e |
| ISSN: | 0032-1052 |
| Popis: | BACKGROUND This study used coarsened exact matching to investigate the effectiveness of the LACE+ index (i.e., length of stay, acuity of admission, Charlson Comorbidity Index, and emergency department visits in the past 6 months) predictive tool in patients undergoing plastic surgery. METHODS Coarsened exact matching was used to assess the predictive ability of the LACE+ index among plastic surgery patients over a 2-year period (2016 to 2018) at one health system (n = 5744). Subjects were matched on factors not included in the LACE+ index such as duration of surgery, body mass index, and race, among others. Outcomes studied included emergency room visits, hospital readmission, and unplanned return to the operating room. RESULTS Three hundred sixty-six patients were matched and compared for quarter 1 to quarter 4 (n = 732, a 28.2 percent match rate); 504 patients were matched for quarter 2 to quarter 4 (n = 1008, a 36.7 percent match rate); 615 patients were matched for quarter 3 to quarter 4 (n = 1230, a 44.8 percent match rate). Increased LACE+ score significantly predicted readmission within 30 days for quarter 1 versus quarter 4 (1.09 percent versus 4.37 percent; p = 0.019), quarter 2 versus quarter 4 (3.57 percent versus 7.34 percent; p = 0.008), and quarter 3 versus quarter 4 (5.04 percent versus 8.13 percent; p = 0.028). Higher LACE+ score also significantly predicted 30-day reoperation for quarter 3 versus quarter 4 (1.30 percent versus 3.90 percent; p = 0.003) and emergency room visits within 30 days for quarter 2 versus quarter 4 (3.17 percent versus 6.75 percent; p = 0.008). CONCLUSION The results of this study demonstrate that the LACE+ index may be suitable as a prediction model for patient outcomes in a plastic surgery population. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, II. |
| Databáze: | OpenAIRE |
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