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Composite score for prediction of 30‐day orthopedic surgery outcomes
Author(s) -
Caplan Ian F.,
Winter Eric,
Glauser Gregory,
Goodrich Stephen,
McClintock Scott D.,
Hume Eric L.,
Malhotra Neil R.
Publication year - 2020
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.24673
Subject(s) - medicine , quartile , orthopedic surgery , charlson comorbidity index , comorbidity , propensity score matching , emergency department , surgery , confidence interval , psychiatry
Abstract The LACE+ (Length of stay, Acuity of admission, Charlson Comorbidity Index score, and Emergency department visits in the past 6 months) risk‐prediction tool has never been tested in an orthopedic surgery population. LACE+ may help physicians more effectively identify and support high‐risk orthopedics patients after hospital discharge. LACE+ scores were retrospectively calculated for all consecutive orthopedic surgery patients (n = 18 893) at a multi‐center health system over 3 years (2016‐2018). Coarsened exact matching was employed to create “matched” study groups with different LACE+ score quartiles (Q1, Q2, Q3, Q4). Outcomes were compared between quartiles. In all, 1444 patients were matched between Q1 and Q4 (n = 2888); 2079 patients between Q2 and Q4 (n = 4158); 3032 patients between Q3 and Q4 (n = 6064). Higher LACE+ scores significantly predicted 30D readmission risk for Q4 vs Q1 and Q4 vs Q3 ( P < .001). Larger LACE+ scores also significantly predicted 30D risk of ED visits for Q4 vs Q1, Q4 vs Q2, and Q4 vs Q3 ( P < .001). Increased LACE+ score also significantly predicted 30D risk of reoperation for Q4 vs Q1 ( P = .018), Q4 vs Q2 ( P < .001), and Q4 vs Q3 ( P < .001).