Validity of the LACE index for identifying frequent early readmissions after hospital discharge in children
The LACE index scoring tool has been designed to predict hospital readmissions in adults. We aimed to evaluate the ability of the LACE index to identify children at risk of frequent readmissions. We analysed data from alive-discharge episodes (1 April 2017 to 31 March 2019) for 6546 males and 5875 f...
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| Veröffentlicht in: | European journal of pediatrics 2021-05, Vol.180 (5), p.1571-1579 |
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| creator | Han, Thang S Fluck, David Fry, Christopher H |
| description | The LACE index scoring tool has been designed to predict hospital readmissions in adults. We aimed to evaluate the ability of the LACE index to identify children at risk of frequent readmissions. We analysed data from alive-discharge episodes (1 April 2017 to 31 March 2019) for 6546 males and 5875 females from birth to 18 years. The LACE index predicted frequent all-cause readmissions within 28 days of hospital discharge with high accuracy: the area under the curve = 86.9% (95% confidence interval = 84.3–89.5%,
p
4 (event rates, 3.7%) were at increased risk of frequent readmissions: age- and sex-adjusted odds ratio = 12.4 (95% confidence interval = 8.0–19.2,
p
4 are at increased risk of frequent readmissions by 14-fold.
• The cutoff of a LACE index of 4 may be a useful level to identify children at increased risk of frequent readmissions. |
| doi_str_mv | 10.1007/s00431-021-03929-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8032568</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2509905191</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-f190f372ccb7fdede8ee5c1f1a055ee73315976139f9592244d36399dcfad3273</originalsourceid><addsrcrecordid>eNp9kUtvEzEUhS0EomnhD7BAltiwGerneLxBqqK2IEXqBtharn2dcZnYwZ5UpL8el5TyWLCwLOt-99x7fBB6Rck7Sog6rYQITjvC2uGa6e7uCVpQwVlHieqfogXhgnQ91foIHdd6Q1qTpsNzdMS5EJpRvUBfv9gp-jjvcQ54HgGvzpbnOCYP33HIBUcPaY5hH9MahwLfdu2JwZZpjwtYv4m1xpwqtmGGgsdct3G2E_axutGWNTQp7MY4-QLpBXoW7FTh5cN9gj5fnH9afuhWV5cfl2erzgkl5i5QTQJXzLlrFTx4GACko4FaIiWA4pxKrXrKddBSMyaE5z3X2rtgPWeKn6D3B93t7noD3rWVi53MtsSNLXuTbTR_V1IczTrfmoFwJvuhCbx9ECi5Oa6zaT4dTJNNkHfVMKEG2X6SiYa--Qe9ybuSmj3DJNGaSKppo9iBciXXWiA8LkOJuc_SHLI0LUvzM0tz15pe_2njseVXeA3gB6C2UlpD-T37P7I_AKjyrH8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2509905191</pqid></control><display><type>article</type><title>Validity of the LACE index for identifying frequent early readmissions after hospital discharge in children</title><source>SpringerLink Journals - AutoHoldings</source><creator>Han, Thang S ; Fluck, David ; Fry, Christopher H</creator><creatorcontrib>Han, Thang S ; Fluck, David ; Fry, Christopher H</creatorcontrib><description>The LACE index scoring tool has been designed to predict hospital readmissions in adults. We aimed to evaluate the ability of the LACE index to identify children at risk of frequent readmissions. We analysed data from alive-discharge episodes (1 April 2017 to 31 March 2019) for 6546 males and 5875 females from birth to 18 years. The LACE index predicted frequent all-cause readmissions within 28 days of hospital discharge with high accuracy: the area under the curve = 86.9% (95% confidence interval = 84.3–89.5%,
p
< 0.001). Two-graph receiver operating characteristic curve analysis revealed the LACE index cutoff to be 4.3, where sensitivity equals specificity, to predict frequent readmissions. Compared with those with a LACE index score = 0–4 (event rates, 0.3%), those with a score > 4 (event rates, 3.7%) were at increased risk of frequent readmissions: age- and sex-adjusted odds ratio = 12.4 (95% confidence interval = 8.0–19.2,
p
< 0.001) and death within 30 days of discharge: OR = 5.0 (95% CI = 1.5–16.7). The ORs for frequent readmissions were between 6 and 14 for children of different age categories (neonate, infant, young child and adolescent), except for patients in the child category (6–12 years) where odds ratio was 2.8.
Conclusion
: The LACE index can be used in healthcare services to identify children at risk of frequent readmissions. Focus should be directed at individuals with a LACE index score above 4 to help reduce risk of readmissions.
What is Known:
• The LACE index scoring tool has been widely used to predict hospital readmissions in adults.
What is New:
• Compared with children with a LACE index score of 0–4 (event rates, 0.3%), those with a score > 4 are at increased risk of frequent readmissions by 14-fold.
• The cutoff of a LACE index of 4 may be a useful level to identify children at increased risk of frequent readmissions.</description><identifier>ISSN: 0340-6199</identifier><identifier>EISSN: 1432-1076</identifier><identifier>DOI: 10.1007/s00431-021-03929-z</identifier><identifier>PMID: 33449219</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; At risk youth ; Children ; Children & youth ; Comorbidity ; Confidence intervals ; Health services ; Hospitals ; Length of stay ; Medicine ; Medicine & Public Health ; Mortality ; Original ; Original Article ; Patients ; Pediatrics ; Quality control ; Sex ratio ; Variables</subject><ispartof>European journal of pediatrics, 2021-05, Vol.180 (5), p.1571-1579</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-f190f372ccb7fdede8ee5c1f1a055ee73315976139f9592244d36399dcfad3273</citedby><cites>FETCH-LOGICAL-c474t-f190f372ccb7fdede8ee5c1f1a055ee73315976139f9592244d36399dcfad3273</cites><orcidid>0000-0003-2570-0938</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00431-021-03929-z$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00431-021-03929-z$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,778,782,883,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33449219$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Han, Thang S</creatorcontrib><creatorcontrib>Fluck, David</creatorcontrib><creatorcontrib>Fry, Christopher H</creatorcontrib><title>Validity of the LACE index for identifying frequent early readmissions after hospital discharge in children</title><title>European journal of pediatrics</title><addtitle>Eur J Pediatr</addtitle><addtitle>Eur J Pediatr</addtitle><description>The LACE index scoring tool has been designed to predict hospital readmissions in adults. We aimed to evaluate the ability of the LACE index to identify children at risk of frequent readmissions. We analysed data from alive-discharge episodes (1 April 2017 to 31 March 2019) for 6546 males and 5875 females from birth to 18 years. The LACE index predicted frequent all-cause readmissions within 28 days of hospital discharge with high accuracy: the area under the curve = 86.9% (95% confidence interval = 84.3–89.5%,
p
< 0.001). Two-graph receiver operating characteristic curve analysis revealed the LACE index cutoff to be 4.3, where sensitivity equals specificity, to predict frequent readmissions. Compared with those with a LACE index score = 0–4 (event rates, 0.3%), those with a score > 4 (event rates, 3.7%) were at increased risk of frequent readmissions: age- and sex-adjusted odds ratio = 12.4 (95% confidence interval = 8.0–19.2,
p
< 0.001) and death within 30 days of discharge: OR = 5.0 (95% CI = 1.5–16.7). The ORs for frequent readmissions were between 6 and 14 for children of different age categories (neonate, infant, young child and adolescent), except for patients in the child category (6–12 years) where odds ratio was 2.8.
Conclusion
: The LACE index can be used in healthcare services to identify children at risk of frequent readmissions. Focus should be directed at individuals with a LACE index score above 4 to help reduce risk of readmissions.
What is Known:
• The LACE index scoring tool has been widely used to predict hospital readmissions in adults.
What is New:
• Compared with children with a LACE index score of 0–4 (event rates, 0.3%), those with a score > 4 are at increased risk of frequent readmissions by 14-fold.
• The cutoff of a LACE index of 4 may be a useful level to identify children at increased risk of frequent readmissions.</description><subject>Age</subject><subject>At risk youth</subject><subject>Children</subject><subject>Children & youth</subject><subject>Comorbidity</subject><subject>Confidence intervals</subject><subject>Health services</subject><subject>Hospitals</subject><subject>Length of stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Quality control</subject><subject>Sex ratio</subject><subject>Variables</subject><issn>0340-6199</issn><issn>1432-1076</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtvEzEUhS0EomnhD7BAltiwGerneLxBqqK2IEXqBtharn2dcZnYwZ5UpL8el5TyWLCwLOt-99x7fBB6Rck7Sog6rYQITjvC2uGa6e7uCVpQwVlHieqfogXhgnQ91foIHdd6Q1qTpsNzdMS5EJpRvUBfv9gp-jjvcQ54HgGvzpbnOCYP33HIBUcPaY5hH9MahwLfdu2JwZZpjwtYv4m1xpwqtmGGgsdct3G2E_axutGWNTQp7MY4-QLpBXoW7FTh5cN9gj5fnH9afuhWV5cfl2erzgkl5i5QTQJXzLlrFTx4GACko4FaIiWA4pxKrXrKddBSMyaE5z3X2rtgPWeKn6D3B93t7noD3rWVi53MtsSNLXuTbTR_V1IczTrfmoFwJvuhCbx9ECi5Oa6zaT4dTJNNkHfVMKEG2X6SiYa--Qe9ybuSmj3DJNGaSKppo9iBciXXWiA8LkOJuc_SHLI0LUvzM0tz15pe_2njseVXeA3gB6C2UlpD-T37P7I_AKjyrH8</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Han, Thang S</creator><creator>Fluck, David</creator><creator>Fry, Christopher H</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2570-0938</orcidid></search><sort><creationdate>20210501</creationdate><title>Validity of the LACE index for identifying frequent early readmissions after hospital discharge in children</title><author>Han, Thang S ; Fluck, David ; Fry, Christopher H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-f190f372ccb7fdede8ee5c1f1a055ee73315976139f9592244d36399dcfad3273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>At risk youth</topic><topic>Children</topic><topic>Children & youth</topic><topic>Comorbidity</topic><topic>Confidence intervals</topic><topic>Health services</topic><topic>Hospitals</topic><topic>Length of stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Quality control</topic><topic>Sex ratio</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Han, Thang S</creatorcontrib><creatorcontrib>Fluck, David</creatorcontrib><creatorcontrib>Fry, Christopher H</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Han, Thang S</au><au>Fluck, David</au><au>Fry, Christopher H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validity of the LACE index for identifying frequent early readmissions after hospital discharge in children</atitle><jtitle>European journal of pediatrics</jtitle><stitle>Eur J Pediatr</stitle><addtitle>Eur J Pediatr</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>180</volume><issue>5</issue><spage>1571</spage><epage>1579</epage><pages>1571-1579</pages><issn>0340-6199</issn><eissn>1432-1076</eissn><abstract>The LACE index scoring tool has been designed to predict hospital readmissions in adults. We aimed to evaluate the ability of the LACE index to identify children at risk of frequent readmissions. We analysed data from alive-discharge episodes (1 April 2017 to 31 March 2019) for 6546 males and 5875 females from birth to 18 years. The LACE index predicted frequent all-cause readmissions within 28 days of hospital discharge with high accuracy: the area under the curve = 86.9% (95% confidence interval = 84.3–89.5%,
p
< 0.001). Two-graph receiver operating characteristic curve analysis revealed the LACE index cutoff to be 4.3, where sensitivity equals specificity, to predict frequent readmissions. Compared with those with a LACE index score = 0–4 (event rates, 0.3%), those with a score > 4 (event rates, 3.7%) were at increased risk of frequent readmissions: age- and sex-adjusted odds ratio = 12.4 (95% confidence interval = 8.0–19.2,
p
< 0.001) and death within 30 days of discharge: OR = 5.0 (95% CI = 1.5–16.7). The ORs for frequent readmissions were between 6 and 14 for children of different age categories (neonate, infant, young child and adolescent), except for patients in the child category (6–12 years) where odds ratio was 2.8.
Conclusion
: The LACE index can be used in healthcare services to identify children at risk of frequent readmissions. Focus should be directed at individuals with a LACE index score above 4 to help reduce risk of readmissions.
What is Known:
• The LACE index scoring tool has been widely used to predict hospital readmissions in adults.
What is New:
• Compared with children with a LACE index score of 0–4 (event rates, 0.3%), those with a score > 4 are at increased risk of frequent readmissions by 14-fold.
• The cutoff of a LACE index of 4 may be a useful level to identify children at increased risk of frequent readmissions.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33449219</pmid><doi>10.1007/s00431-021-03929-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-2570-0938</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Age At risk youth Children Children & youth Comorbidity Confidence intervals Health services Hospitals Length of stay Medicine Medicine & Public Health Mortality Original Original Article Patients Pediatrics Quality control Sex ratio Variables |
| title | Validity of the LACE index for identifying frequent early readmissions after hospital discharge in children |
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