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LACE index

Lian Leng Low, Nan Liu, Kheng Hock Lee, Marcus Eng Hock Ong, Sijia Wang, Xuan Jing, Julian Thumboo
BACKGROUND: An accurate risk stratification tool is critical in identifying patients who are at high risk of frequent hospital readmissions. While 30-day hospital readmissions have been widely studied, there is increasing interest in identifying potential high-cost users or frequent hospital admitters. In this study, we aimed to derive and validate a risk stratification tool to predict frequent hospital admitters. METHODS: We conducted a retrospective cohort study using the readily available clinical and administrative data from the electronic health records of a tertiary hospital in Singapore...
April 8, 2017: BMC Medical Informatics and Decision Making
Robert Robinson, Tamer Hudali
INTRODUCTION: Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP) program. Validated risk assessment tools such as the HOSPITAL score and LACE index have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. This study aims to evaluate the utility of HOSPITAL score and LACE index for predicting hospital readmission within 30 days in a moderate-sized university affiliated hospital in the midwestern United States...
2017: PeerJ
James R Staley, Stephen Burgess
Mendelian randomization, the use of genetic variants as instrumental variables (IV), can test for and estimate the causal effect of an exposure on an outcome. Most IV methods assume that the function relating the exposure to the expected value of the outcome (the exposure-outcome relationship) is linear. However, in practice, this assumption may not hold. Indeed, often the primary question of interest is to assess the shape of this relationship. We present two novel IV methods for investigating the shape of the exposure-outcome relationship: a fractional polynomial method and a piecewise linear method...
May 2017: Genetic Epidemiology
Christo El Morr, Liane Ginsburg, Seungree Nam, Susan Woollard
BACKGROUND: The LACE index was designed to predict early death or unplanned readmission after discharge from hospital to the community. However, implementing the LACE tool in real time in a teaching hospital required practical unavoidable modifications. OBJECTIVE: The purpose of this study was to validate the implementation of a modified LACE index (LACE-rt) and test its ability to predict readmission risk using data in a hospital setting. METHODS: Data from the Canadian Institute for Health Information's Discharge Abstract Database (DAD), the National Ambulatory Care Reporting System (NACRS), and the hospital electronic medical record for one large community hospital in Toronto, Canada, were used in this study...
March 8, 2017: Interactive Journal of Medical Research
Kristine A Donovan, Mary Turney, C Edward Emnett, Amber Lamoreaux, Diane G Portman
177 Background: The 30-day readmission rate is established as an important indicator of quality of care. The LACE index is commonly used in the general medical setting to predict readmission but its ability to predict readmission with sensitivity and specificity in the oncology population has not yet been examined. At our cancer center, palliative care (PC) consultation is associated with an increased risk for readmission but it is not an element in the LACE index. METHODS: We sought to characterize the operating characteristics of the LACE Index using receiver operating characteristics analyses to predict unplanned readmissions to our cancer center over a 6-week period beginning March 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Paul J Handal, John W Lace
This study examined measures of religion and spirituality in a sample of male and female emerging adult college students whose parents were either divorced or intact using the Personal Religious Inventory, the Duke University Religion Index, the Daily Spiritual Experiences Scale, the Spiritual Transcendence Scale, and the Spiritual Involvement and Beliefs Scale. Data were collected online, and 66% of participants received extra credit for participating. A main effect of sex was found, as females reported significantly higher scores than men on all but one measure of religion and spirituality, and the dataset was separated by sex...
December 23, 2016: Journal of Religion and Health
Lian Leng Low, Nan Liu, Sijia Wang, Julian Thumboo, Marcus Eng Hock Ong, Kheng Hock Lee
BACKGROUND: To reduce readmissions, it may be cost-effective to consider risk stratification, with targeting intervention programs to patients at high risk of readmissions. In this study, we aimed to derive and validate a prediction model including several novel markers of hospitalization severity, and compare the model with the LACE index (Length of stay, Acuity of admission, Charlson comorbidity index, Emergency department visits in past 6 months), an established risk stratification tool...
2016: PloS One
Gregory M Garrison, Paul M Robelia, Jennifer L Pecina, Nancy L Dawson
RATIONALE, AIMS AND OBJECTIVES: Hospital readmission within 30 days of discharge occurs in almost 20% of US Medicare patients and may be a marker of poor quality inpatient care, ineffective hospital to home transitions, or disease severity. Within a patient centered medical home, care transition interventions may only be practical from cost and staffing perspectives if targeted at patients with the greatest risk of readmission. Various scoring algorithms attempt to predict patients at risk for 30-day readmission, but head-to-head comparison of performance is lacking...
October 3, 2016: Journal of Evaluation in Clinical Practice
Payam Yazdan-Ashoori, Shun Fu Lee, Quazi Ibrahim, Harriette G C Van Spall
UNLABELLED: The Length of stay, Acuity, Comorbidities, Emergency department visits in prior 6 months (LACE) index threshold of 10 predicts readmission or death in general medical patients in administrative databases. We assessed whether the unadjusted LACE index, computed at the bedside, can predict 30-day outcomes in patients hospitalized for heart failure. METHODS: We used logistic regression with LACE as the continuous predictor and 30-day readmissions and 30-day readmission or death as outcomes...
September 2016: American Heart Journal
Babar Bashir, Doron Schneider, Mary C Naglak, Thomas M Churilla, Marguerite Adelsberger
OBJECTIVES: Factors that influence the likelihood of readmission for chronic obstructive pulmonary disease (COPD) patients and the impact of posthospital care coordination remain uncertain. LACE index (L = length of stay, A = Acuity of admission; C = Charlson comorbidity index; E = No. of emergency department (ED) visits in last 6 months) is a validated tool for predicting 30-days readmissions for general medicine patients. We aimed to identify variables predictive of COPD readmissions including LACE index and determine the impact of a novel care management process on 30-day all-cause readmission rate...
August 2016: Hospital Practice (Minneapolis)
Amanda S Mixon, Kathryn Goggins, Susan P Bell, Eduard E Vasilevskis, Samuel Nwosu, Jonathan S Schildcrout, Sunil Kripalani
BACKGROUND, OBJECTIVE: Patients' self-reported preparedness for discharge has been shown to predict readmission. It is unclear what differences exist in the predictive abilities of 2 available discharge preparedness measures. To address this gap, we conducted a comparison of these measures. DESIGN, SETTING, PATIENTS: Adults hospitalized for cardiovascular diagnoses were enrolled in a prospective cohort. MEASUREMENTS: Two patient-reported preparedness measures assessed during postdischarge calls: the 11-item Brief Prescriptions, Ready to re-enter community, Education, Placement, Assurance of safety, Realistic expectations, Empowerment, Directed to appropriate services (B-PREPARED) and the 3-item Care Transitions Measure (CTM-3)...
September 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Oanh Kieu Nguyen, Anil N Makam, Christopher Clark, Song Zhang, Bin Xie, Ferdinand Velasco, Ruben Amarasingham, Ethan A Halm
BACKGROUND: Incorporating clinical information from the full hospital course may improve prediction of 30-day readmissions. OBJECTIVE: To develop an all-cause readmissions risk-prediction model incorporating electronic health record (EHR) data from the full hospital stay, and to compare "full-stay" model performance to a "first day" and 2 other validated models, LACE (includes Length of stay, Acute [nonelective] admission status, Charlson Comorbidity Index, and Emergency department visits in the past year), and HOSPITAL (includes Hemoglobin at discharge, discharge from Oncology service, Sodium level at discharge, Procedure during index hospitalization, Index hospitalization Type [nonelective], number of Admissions in the past year, and Length of stay)...
July 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Liping Tong, Cole Erdmann, Marina Daldalian, Jing Li, Tina Esposito
BACKGROUND: This paper explores the importance of electronic medical records (EMR) for predicting 30-day all-cause non-elective readmission risk of patients and presents a comparison of prediction performance of commonly used methods. METHODS: The data are extracted from eight Advocate Health Care hospitals. Index admissions are excluded from the cohort if they are observation, inpatient admissions for psychiatry, skilled nursing, hospice, rehabilitation, maternal and newborn visits, or if the patient expires during the index admission...
February 27, 2016: BMC Medical Research Methodology
Edward Yian, Hui Zhou, Ariyon Schreiber, Jeff Sodl, Ron Navarro, Anshuman Singh, Nikita Bezrukov
CONTEXT: Surgical treatment for proximal humerus fractures has increased exponentially. Recent health care policies incentivize centers to reduce hospital readmission rates. Better understanding of risk factors for readmission and early mortality in this population will assist in identifying favorable risk-benefit patient profiles. OBJECTIVE: To identify incidence and risk factors of 30-day hospital readmission rate and 1-year mortality rate after open surgery of proximal humerus fractures...
2016: Permanente Journal
Lian Leng Low, Kheng Hock Lee, Marcus Eng Hock Ong, Sijia Wang, Shu Yun Tan, Julian Thumboo, Nan Liu
The LACE index (length of stay, acuity of admission, Charlson comorbidity index, CCI, and number of emergency department visits in preceding 6 months) derived in Canada is simple and may have clinical utility in Singapore to predict readmission risk. We compared the performance of the LACE index with a derived model in identifying 30-day readmissions from a population of general medicine patients in Singapore. Additional variables include patient demographics, comorbidities, clinical and laboratory variables during the index admission, and prior healthcare utilization in the preceding year...
2015: BioMed Research International
Zuzana Feketeová, Veronika Hulejová Sládkovičová, Barbara Mangová, Andrea Pogányová, Ivan Šimkovic, Miroslav Krumpál
With respect to acidic, cyanide-laced tailings, the data about in situ toxicity and biological activity in highly polluted environment are often lacking. The aim of this study was to assess the microbial characteristics, composition of oribatid mite species, and level of genotoxic impact on plants in the area of inactive tailings pond (Horná Ves, Kremnica region). Sampling of the tailings, soils and selected plant species was carried out in spring of 2012. Trace element analysis (inductively coupled plasma emission and mass spectrometry) showed that concentration of Pb, Zn, and Cu in the tailings is approximately in thousands of ppm (mg kg(-1))...
January 2016: Ecotoxicology
Molywan Vat, Carol Common, Andrea Maria Laizner, Coralie Borduas, Christine Maheu
AIMS AND OBJECTIVES: To understand the patients' reasons for returning to the emergency department soon after their discharge from an internal medicine unit and to compare these reasons with the liaison nurse clinician's risk assessment tools used for discharge planning. BACKGROUND: Returns to the emergency departments soon after discharge from the hospital are a recurrent problem. Factors precipitating readmission to hospital have been analysed through the lens of health care providers, but few studies have explored the patients' perspectives on their reasons for returning to the emergency departments...
December 2015: Journal of Clinical Nursing
Darren Lau, Raj S Padwal, Sumit R Majumdar, Jenelle L Pederson, Sara Belga, Sharry Kahlon, Miriam Fradette, Debbie Boyko, Finlay A McAlister
BACKGROUND: Early readmissions to hospital after discharge are common, and clinicians cannot accurately predict their occurrence. We examined whether patients who feel unready at the time of discharge have increased readmissions or death within 30 days. METHODS: This was a prospective cohort study of adult patients discharged home from 2 tertiary care hospitals in Edmonton, Alberta, Canada, between October 2013 and November 2014. Patient-reported discharge readiness was measured with an 11-point Likert response scale, with scores <7 indicating subjective unreadiness...
January 2016: American Journal of Medicine
Laura R Bronstein, Paul Gould, Shawn A Berkowitz, Gary D James, Kris Marks
This study assessed how a social work-led care coordination intervention would reduce the within-30-day hospital readmission rate among moderate- and high-risk patients age 50 years or older. Authors ran a randomized controlled trial to determine whether there was a significant difference in within-30-day readmission rates between patients receiving usual care post-discharge and those receiving intervention from an MSW intern (one home visit and one to two phone calls). Results were obtained using a sample of hospitalized patients with a LACE index score of 7 or higher (N = 89)...
July 2015: Social Work
LeeAnna Spiva, Marti Hand, Lewis VanBrackle, Frank McVay
BACKGROUND: Hospital readmission is an adverse patient outcome that is serious, common, and costly. For hospitals, identifying patients at risk for hospital readmission is a priority to reduce costs and improve care. PURPOSE: The purposes were to validate a predictive algorithm to identify patients at a high risk for preventable hospital readmission within 30 days after discharge and determine if additional risk factors enhance readmission predictability. METHODS: A retrospective study was conducted on a randomized sample of 598 patients discharged from a Southeast community hospital...
January 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
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