LACE+ Index as Predictor of 30-Day Readmission in Brain Tumor Population.
Adult
Aged
Aged, 80 and over
Brain Neoplasms
/ therapy
Comorbidity
Emergency Service, Hospital
Female
Hospitalization
/ statistics & numerical data
Hospitals
/ statistics & numerical data
Humans
Length of Stay
Logistic Models
Male
Middle Aged
Patient Discharge
/ statistics & numerical data
Patient Readmission
/ statistics & numerical data
ROC Curve
Risk Factors
Brain tumors
Discharge predictive tool
Hospital readmissions
LACE+ index
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
30
01
2019
revised:
14
03
2019
accepted:
15
03
2019
pubmed:
31
3
2019
medline:
15
1
2020
entrez:
31
3
2019
Statut:
ppublish
Résumé
The LACE+ index (Length of stay, Acuity of admission, Charlson Comorbidity Index score, and Emergency department [ED] visits in the past 6 months) is a tool used to predict 30-day readmissions. We sought to examine this predictive tool in patients undergoing brain tumor surgery. Admissions and readmissions for patients undergoing craniotomy for supratentorial neoplasm at a single multihospital academic medical center were analyzed. All brain tumor cases for which the patient was alive at 30 days after surgery were included (n = 352). Simple logistic regression analyses were used to assess the ability of the LACE+ index and subsequent single variables to accurately predict the outcome measures of 30-day readmission, reoperation, and ED visit. Analysis of the model's or variable's discrimination was determined by the receiver operating characteristic curve as represented by the C-statistic. The sample included admissions for craniotomy for supratentorial neoplasm (n = 352). Assessment of the LACE+ index demonstrates a 1.02× increased odds of 30-day readmission for every 1-unit increase in LACE+ score (P = 0.031, CI = 1.00-1.03). Despite this, analysis of the receiver operating characteristic curve indicates that LACE+ index has poor specificity in predicting 30-day readmission (C-statistic = 0.58). A 1-unit increase in LACE+ score also predicts a 0.98× reduction in odds of home discharge (P < 0.001, CI = 0.97-0.99, C-statistic = 0.70). But LACE+ index does not predict 30-day reoperation (P = 0.945) or 30-day ED visits (P = 0.218). The results of this study demonstrate that the LACE+ index is not yet suitable as a prediction model for 30-day readmission in a brain tumor population.
Sections du résumé
BACKGROUND
BACKGROUND
The LACE+ index (Length of stay, Acuity of admission, Charlson Comorbidity Index score, and Emergency department [ED] visits in the past 6 months) is a tool used to predict 30-day readmissions. We sought to examine this predictive tool in patients undergoing brain tumor surgery.
METHODS
METHODS
Admissions and readmissions for patients undergoing craniotomy for supratentorial neoplasm at a single multihospital academic medical center were analyzed. All brain tumor cases for which the patient was alive at 30 days after surgery were included (n = 352). Simple logistic regression analyses were used to assess the ability of the LACE+ index and subsequent single variables to accurately predict the outcome measures of 30-day readmission, reoperation, and ED visit. Analysis of the model's or variable's discrimination was determined by the receiver operating characteristic curve as represented by the C-statistic.
RESULTS
RESULTS
The sample included admissions for craniotomy for supratentorial neoplasm (n = 352). Assessment of the LACE+ index demonstrates a 1.02× increased odds of 30-day readmission for every 1-unit increase in LACE+ score (P = 0.031, CI = 1.00-1.03). Despite this, analysis of the receiver operating characteristic curve indicates that LACE+ index has poor specificity in predicting 30-day readmission (C-statistic = 0.58). A 1-unit increase in LACE+ score also predicts a 0.98× reduction in odds of home discharge (P < 0.001, CI = 0.97-0.99, C-statistic = 0.70). But LACE+ index does not predict 30-day reoperation (P = 0.945) or 30-day ED visits (P = 0.218).
CONCLUSIONS
CONCLUSIONS
The results of this study demonstrate that the LACE+ index is not yet suitable as a prediction model for 30-day readmission in a brain tumor population.
Identifiants
pubmed: 30926557
pii: S1878-8750(19)30849-6
doi: 10.1016/j.wneu.2019.03.169
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e443-e448Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.