Composite Score for Outcome Prediction in Gynecologic Surgery Patients. Issue 3 (May 2021)

• Record Type: Journal Article
• Authors: Glauser, Gregory; Winter, Eric; Caplan, Ian F.; Goodrich, Stephen; McClintock, Scott D.; Srinivas, Sindhu K.; Malhotra, Neil R.
• Is Part Of: Journal for healthcare quality. Volume 43:Issue 3(2021)
• Publication Date: 2021-05
• Subjects: outcome prediction -- readmissions -- gynecologic surgery -- LACE+ index -- coarsened exact matching; Medical care -- Quality control -- Periodicals; Quality assurance -- Periodicals; 362.1
• DOI: 10.1097/JHQ.0000000000000254
• Languages: English
• ISSNs: 1062-2551

Abstract

ABSTRACT: Background: The LACE+ index is a well-studied metric that compacts patient data in an effort to assess readmission risk. Purpose: Assess the capacity of LACE+ scores for predicting short-term undesirable outcomes in an entire single-center population of patients undergoing gynecologic surgery. Importance and Relevance to Healthcare Quality: Proactive identification of high-risk patients, with tools such as the LACE+ index, may serve as the first step toward appropriately engaging resources for reducing readmissions. Methods: This study was a retrospective analysis that used coarsened exact matching. All gynecologic surgery cases over 2 years within a single health system (n = 12, 225) were included for analysis. Outcomes of interest were unplanned readmission, emergency room (ER) evaluation, and return to surgery. Composite LACE+ scores were separated into quartiles and matched. For outcome comparison, matched patients were assessed by LACE+ quartile, using Q4 as the reference group. Results: Increasing LACE+ score reflected a higher rate of readmission ( p = .003, p = .001) and visits to the ER at 30 postoperative days ( p < .001). Conclusion: The data presented here suggest that LACE+ index is a viable metric for patient outcome prediction following gynecologic surgery.