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Primary care
HOSPITAL Score, LACE Index and LACE+ Index as predictors of 30-day readmission in patients with heart failure
  1. Abdisamad M Ibrahim1,
  2. Cameron Koester1,
  3. Mohammad Al-Akchar2,
  4. Nitin Tandan1,
  5. Manjari Regmi1,
  6. Mukul Bhattarai2,
  7. Basma Al-Bast1,
  8. Abhishek Kulkarni2,
  9. Robert Robinson1
  1. 1Internal Medicine, SIU School of Medicine, Springfield, Illinois, USA
  2. 2Division of Cardiology, SIU School of Medicine, Springfield, Illinois, USA
  1. Correspondence to Dr Abdisamad M Ibrahim, Internal Medicine, SIU School of Medicine, Springfield, IL 62781, USA; aibrahim0912{at}gmail.com

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.

  • heart failure readmission
  • readmission
  • HOSPITAL Score
  • LACE Index
  • LACE+ Index
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Footnotes

  • Twitter @aibrahim0912

  • Contributors All authors contributed to the preparation of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Institutional review board review for this study was obtained from the Springfield Committee for Research Involving Human Subjects. This study was determined not to meet the criteria for research involving human subjects according to 45 CFR 46.101 and 45 CFR 46.102.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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