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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

    LACE Index for Readmission

    Predicts 30-day readmission or death in patients on medicine and surgery wards.

    INSTRUCTIONS

    Use in patients ≥18 years old.

    When to Use
    Pearls/Pitfalls
    Why Use

    Adult patients admitted to medical or surgical wards.

    • Length of stay cannot be factored in until day of discharge, thus limiting real-time use.
    • Note that mean age of study participants was 61 years in the derivation LACE study.
    • Validated for use in congestive heart failure patients.
    • The LACE was externally validated in 1,000,000 Ontarians in the original publication, and has since been tested in several external populations (Spiva 2016, Low 2016, Low 2017, Shaffer 2019).
    • A more detailed version of LACE (LACE+) has been created with increased discrimination.
    • A modified version of the Charlson Comorbidity Index, excluding age, was used based on Schneeweiss 2003.
    • Can identify patients that might benefit from post-discharge nursing care.
    • Predicts rates of readmission, with some studies identifying the number of ED visits in 6 months which is a component of the LACE as the major predictor of readmission.
    • Has similar discriminating ability as other scores such as the HOSPITAL score and 8Ps.
    1
    +1
    2
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    3
    +3
    4-6
    +4
    7-13
    +5
    ≥14
    +7
    No
    0
    Yes
    +3
    0 points
    0
    1 points
    +1
    2 points
    +2
    3 points
    +3
    ≥4 points
    +5
    0
    0
    1
    +1
    2
    +2
    3
    +3
    ≥4
    +4

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Carl van Walraven

    About the Creator

    Carl van Walraven, MD, is a professor of medicine and epidemiology at the University of Ottawa. He is also a senior scientist of the Clinical Epidemiology Program at the Ottawa Hospital Research Institute (OHRI) as well as a site director for the Institute for Clinical Evaluative Sciences at the University of Ottawa. He is an active researcher focusing mainly on quality improvement, continuity of care/information, and administrative database research.

    To view Dr. Carl van Walraven's publications, visit PubMed

    Content Contributors
    • Chukwudi Obiagwu, MBBS
    About the Creator
    Dr. Carl van Walraven
    Content Contributors
    • Chukwudi Obiagwu, MBBS