HOSPITAL Score, LACE Index and LACE+ Index as predictors of 30-day readmission in patients with heart failure

Abstract

This study aimed to evaluate the accuracy of the HOSPITAL Score (Haemoglobin level at discharge, Oncology at discharge, Sodium level at discharge, Procedure during hospitalization, Index admission, number of hospital admissions, Length of stay) LACE index (Length of stay, Acute/emergent admission, Charlson comorbidy index score, Emerency department visits in previous 6 months) and LACE+ index in predicting 30-day readmission in patients with diastolic dysfunction. Heart failure remains one of the most common hospital readmissions in adults, leading to significant morbidity and mortality. Different models have been used to predict 30-day hospital readmissions. All adult medical patients discharged from the SIU School of Medicine Hospitalist service from 12 June 2016 to 12 June 2018 with an International Classification of Disease, 10th Revision, Clinical Modification diagnosis of diastolic heart failure were studied retrospectively to evaluate the performance of the HOSPITAL Score, LACE index and LACE+ index readmission risk prediction tools in this patient population. Of the 730 patient discharges with a diagnosis of heart failure with preserved ejection fraction (HFpEF), 692 discharges met the inclusion criteria. Of these discharges, 189 (27%) were readmitted to the same hospital within 30 days. A receiver operating characteristic evaluation showed C-statistic values to be 0.595 (95% CI 0.549 to 0.641) for the HOSPITAL Score, 0.551 (95% CI 0.503 to 0.598) for the LACE index and 0.568 (95% CI 0.522 to 0.615) for the LACE+ index, indicating poor specificity in predicting 30-day readmission. The result of this study demonstrates that the HOSPITAL Score, LACE index and LACE+ index are not effective predictors of 30-day readmission for patients with HFpEF. Further analysis and development of new prediction models are needed to better estimate the 30-day readmission rates in this patient population.

Prediction of hospital visits for the general inpatient care using floating catchment area methods: a reconceptualization of spatial accessibility

“…Other studies found that the complication rate of a hospital as well as the readmission of patients represent major influencing factors [38,39]. Ibrahim et al examined the readmission rate of heart failure patients but failed to demonstrate an influence of medical scores on the 30-day readmission rate [39]. Still, medical aspects are likely to have an influence on the hospital choice and should therefore be considered whenever possible.…”

Frailty and Sarcopenia Assessment upon Hospital Admission to Internal Medicine Predicts Length of Hospital Stay and Re-Admission: A Prospective Study of 980 Patients

“…Hospital readmissions are a worldwide, major health-care burden, with a negative impact on patient health, public health, and healthcare systems' associated national financial burden. Previous publications describe the heavy toll of hospital (non-surgical) re-admissions while the same researchers and others attempted various strategies for either predicting the risk for readmission and proactively reducing it (albeit with conflicting results) [5][6][7][8][9][10].…”

Heart Failure with Preserved Ejection Fraction and 30-Day Readmission

“…11,13,14,15 In one retrospective study that included HFpEF patients, both HOSPITAL and LACE index did not show association with increased readmissions. 16 Very few studies have focused determining the association of the type of heart failure in hospital readmissions. 17 This provides a motivation to explore the types of heart failure and identify their association with hospital readmission.…”