Evidence map›Paper›PMID 31364712›Full record

ArticleNeurosurgery2020

Validation of the LACE Index (Length of Stay, Acuity of Admission, Comorbidities, Emergency Department Use) in the Adult Neurosurgical Patient Population.

Joseph R Linzey, Jeffrey L Nadel, D Andrew Wilkinson, Venkatakrishna Rajajee, Badih J Daou, Aditya S Pandey

Abstract readValidation Study
In one paragraph

Article in Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Joseph R LinzeySchool of Medicine, University of Michigan, Ann Arbor, Michigan.
Jeffrey L NadelSchool of Medicine, University of Michigan, Ann Arbor, Michigan.
D Andrew WilkinsonDepartment of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
Venkatakrishna RajajeeDepartment of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
Badih J DaouDepartment of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
Aditya S PandeyDepartment of Neurosurgery, University of Michigan, Ann Arbor, Michigan.

Funding

NRSA Training CoreTL1TR002242 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLINSTAT, MICHAEL ALLAN · 2017 to 2021
$2.8M
NCATS NIH HHS TL1 TR002242
6 · The paper itself

Abstract

backgroundThe LACE index (Length of stay, Acuity of admission, Comorbidities, Emergency department use) quantifies the risk of mortality or unplanned readmission within 30 d after hospital discharge. The index was validated originally in a large, general population and, subsequently, in several specialties, not including neurosurgery.

objectiveTo determine if the LACE index accurately predicts mortality and unplanned readmission of neurosurgery patients within 30 d of discharge.

methodsWe performed a retrospective, cohort study of consecutive neurosurgical procedures between January 1 and September 29, 2017 at our institution. The LACE index and other clinical data were abstracted. Data analysis included univariate and multivariate logistic regressions.

resultsOf the 1,054 procedures on 974 patients, 52.7% were performed on females. Mean age was 54.2 ± 15.4 yr. At time of discharge, the LACE index was low (1-4) in 58.3% of patients, moderate (5-9) in 32.4%, and high (10-19) in 9.3%. Rates of readmission and mortality within 30 d were 7.0, 11.4, and 14.3% in the low-, moderate-, and high-risk groups, respectively. Moderate-risk (odds ratio [OR] 1.62, 95% CI 1.02-2.56, P = .04) and high-risk LACE indexes (OR 2.20, 95% CI 1.15-4.19, P = .02) were associated with greater odds of readmission or mortality, adjusting for all variables. Additionally, longer operations (OR 1.11, 95% CI 1.02-1.21, P = .02) had greater odds of readmission. Specificity of the high-risk score to predict 30-d readmission or mortality was 91.2%.

conclusionA moderate- or high-risk LACE index can be applied to neurosurgical populations to predict 30-d readmission and mortality. Longer operations are potential predictors of readmission or mortality.

Indexed as

Patient ReadmissionPostoperative ComplicationsSeverity of Illness IndexAdultAgedCohort StudiesComorbidityEmergency Service, HospitalFemaleHumansLength of StayMaleMiddle AgedNeurosurgical ProceduresRetrospective StudiesRisk AssessmentLACE indexMortalityOutcome predictionReadmissionsRisk assessmentSurgery length

Identifiers

PMID31364712
PMCPMC8204782

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.