Composite Score for Outcome Prediction in Gynecologic Surgery Patients

Background: The LACE+ index is a well-studied metric that compacts patient data in an effort to assess readmission risk. Purpose: Assess the capacity of LACE+ scores for predicting short-term undesirable outcomes in an entire single-center population of patients undergoing gynecologic surgery. Importance and Relevance to Healthcare Quality: Proactive identification of high-risk patients, with tools such as the LACE+ index, may serve as the first step toward appropriately engaging resources for reducing readmissions. Methods: This study was a retrospective analysis that used coarsened exact matching. All gynecologic surgery cases over 2 years within a single health system (n = 12,225) were included for analysis. Outcomes of interest were unplanned readmission, emergency room (ER) evaluation, and return to surgery. Composite LACE+ scores were separated into quartiles and matched. For outcome comparison, matched patients were assessed by LACE+ quartile, using Q4 as the reference group. Results: Increasing LACE+ score reflected a higher rate of readmission (p = .003, p = .001) and visits to the ER at 30 postoperative days (p < .001). Conclusion: The data presented here suggest that LACE+ index is a viable metric for patient outcome prediction following gynecologic surgery.