Hepatopancreatobiliary readmission score out performs administrative LACE+ index as a predictive tool of readmission

Abstract

BackgroundThis study aims to compare the LACE + readmission index to a novel hepatopancreatobiliary readmission risk score (HRRS) in predicting post-operative hepatopancreatobiliary (HPB) cancer patient readmissions. MethodsA retrospective review of 104 postoperative HPB cancer patients from January 2017 to July of 2019 was performed. Univariable and multivariable analyses were utilized. ResultsThe LACE + index did not predict 30-day (OR 1.01, 95% CI, 0.97–1.05, p = 0.81, c-statistic = 0.52) or 90-day (OR 1.02, 95% CI, 0.98–1.05, p = 0.43) readmission. Patients readmitted within 30 days had significantly increased HRRS scores compared to those who were not (0 vs 34, p < 0.001). A single unit increase in HRRS corresponded to a 6.5% increased risk of readmission; (OR 1.065, 95% CI, 1.038–1.094, p < 0.0001). HRRS independently predicted 30-day (OR 1.07, 95% CI, 1.04–1.11, p < 0.0001) and 90-day postoperative readmission (OR 1.05, 95% CI 1.03–1.08, p < 0.0001). ConclusionsHRRS better predicts postoperative readmissions for HPB surgical patients compared to LACE+. Accurate assessment of postoperative readmission must include readmission scores focused on clinically relevant perioperative parameters.