Background:

One-fifth of Medicare patients are readmitted to the hospital an annual cost of $17.4 billion. The LACE Index (Length of stay, Acuity of the admission, Co-morbidities, and Emergency department visits in the previous 6 months) is a validated tool for readmissions within 30 days. We tested this on liver transplant readmissions at a large liver transplant center.

Method:

Retrospective review of liver transplant recipients from 2012-2015 (N= 321) was performed. Patient deaths prior to discharge (N=12) and >30 day primary admissions (N=47) were excluded. The LACE index was calculated for all patients. MELD, discharge creatinine, white blood cell count, and demographic data were analyzed using ANOVA and Pearson Correlatysis.ion anal

Results:

76 patients (29%) were readmitted within 30-days. Readmits had slightly higher LACE scores (mean 11.6 vs 10.9, p=0.04). A LACE threshold >10 yielded a 35% readmission rate, compared to19% for <10 (p=0.01, sensitivity 76%, specificity 41%). LACE Index correlated with MELD, low WBC, female sex, and elevated creatinine. Other variables were not correlated to readmission rates.

Conclusion:

The LACE index can help identify liver transplant patients at risk for 30-day readmission. Besides LACE, neither MELD nor other variables correlated with readmission. These data support the LACE Index as a valuable tool to intervene in patients identified at high-risk for readmission.

CITATION INFORMATION: Masoumi A, Barth R, LaMattina J, Bruno D, Hebert L, Schluterman N, Hanish S. LACE Index Risk Assessment Tool Predicts Liver Transplant Readmissions. Am J Transplant. 2016;16 (suppl 3).

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