1117: EVALUATION OF PREDICTIVE VALUE OF LACE SCORE FOR 30-DAY READMISSION FOR PNEUMONIA

Abstract

Introduction: Patients hospitalized with community-acquired pneumonia (CAP) have a 30-day readmission rate of up to 25%, likely secondary to the high comorbidity burden in this patient population. Thirty-day hospital readmission rates are used by the Center for Medicare and Medicaid Services (CMS) as a performance measure to determine hospital reimbursement rates. The LACE score (length of stay, acuity of admission, comorbidities, and emergency department visits within the last six months) was designed to predict the risk of 30-day hospital readmissions to identify patients at risk for 30-day readmission. Herein, we assessed the predictive value of the LACE score, specifically in stratifying patients admitted to the hospital with a diagnosis of CAP for their risk of 30-day readmission. Methods: In this retrospective cohort study, all patients above 18 years of age admitted to our hospital during 2019 with a CAP diagnosis were included. Via chart review, the patient’s clinical characteristics, comorbidity burden, and hospital readmissions within 30-days of discharge were recorded. Logistic regression models were built to assess the predictive value of each variable for 30-day readmission after discharge. Results: A total of 128 patients (median age 65, IQR 54-78, 46.9% females) were included in the study. Fourteen (10.9%) patients required ICU stay, and 6(4.7%) patients died. Within 30 days of discharge from the hospital, 20 (15.6%) of patients were re-evaluated in the emergency department (ED), and 19 (14.8%) were re-admitted. Factors associated with readmission include LACE score on admission (OR 1.21 (1.02-1.47), p-value 0.02), length of stay (OR 1.10 (1.01-1.20), p-value 0.02), and number of ED visits within the last six months (OR 1.70 (1.22-2.49), p-value 0.003). Conclusions: A higher LACE score or behavior of frequent ED visits is associated with a higher chance of hospital readmission in patients with community-acquired pneumonia after discharge. LACE score can be used as a tool by physicians and case managers to identify patients at risk for 30-day readmission after discharge, and closer follow-ups may be arranged in this high-risk population.