Evidence map›Paper›PMID 40059292›Full record

ArticleWorld journal of surgery2025

Using Natural Language Processing in the LACE Index Scoring Tool to Predict Unplanned Trauma and Surgical Readmissions in South Africa.

Umit Tokac, Jennifer Chipps, Petra Brysiewicz, John Bruce, Damian Clarke

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Article in World journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Umit TokacCollege of Nursing, University of Missouri-Saint Louis, Saint Louis, Missouri, USA.
Jennifer ChippsChair, Digital Health, Faculty of Community Health Sciences, University of the Western Cape, Cape Town, South Africa.
Petra BrysiewiczSchool of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa.
John BruceDepartment of Surgery, University of KwaZulu-Natal, Durban, South Africa.
Damian ClarkeDepartment of Surgery, University of KwaZulu-Natal, Durban, South Africa.

Funding

South African Medical Research CouncilUniversity of Missouri South Africa Education Program
6 · The paper itself

Abstract

backgroundUnplanned and potentially avoidable readmission within 30 days post discharge is a major financial burden.

aimTo use text-based electronic patient records to calculate the Charlson Comorbidity Index (CCI) score using a natural language processing technique to establish the feasibility and usefulness of the text-based electronic patient records in identifying patients at risk for unplanned readmission.

methodsA retrospective review of electronic patient records for general and trauma surgery in a hospital in South Africa (2012-2022) was conducted using the LACE score. Validated sentiment analysis analyzed free text components of electronic patient records to compute the CCI score and to establish the feasibility and usefulness of the LACE score in identifying patients at risk for unplanned readmission.

resultsTrauma surgery patients had a mean LACE score of 5.91 (SD = 2.41), with 8.44% scoring 10 or higher and a specificity and sensitivity of 91.63% and 13.81%, respectively. The general surgery patients had a mean LACE score of 7.75 (SD = 3.04), with 10.63% scoring 10 or higher and a specificity of 71.47% and a sensitivity of 44.80%, respectively. Logistic regression analysis revealed that LACE scores significantly predicted unplanned readmissions in both trauma (β = 0.11, p < 0.001; OR = 1.112, 95% CI [1.082, 1.143]) and general surgery (β = 0.15, p < 0.001; OR = 1.162, 95% CI [1.130, 1.162]) patients.

conclusionThe LACE score demonstrated the predictive value for readmission in trauma and general surgery patients. The LACE score was relatively effective in identifying patients who were less likely to be readmitted but showed limitations in identifying patients at higher risk of readmission. However, the successful use of natural language processing for data extraction of comorbidities shows promise on addressing the challenges around text-based medical records.

Indexed as

Electronic Health RecordsNatural Language ProcessingPatient ReadmissionSurgical Procedures, OperativeWounds and InjuriesAdultAgedComorbidityFeasibility StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentSouth Africaglobal surgeryoutcomestrauma

Identifiers

PMID40059292
PMCPMC11994145

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