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Urology ; 134: 109-115, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31487509

ABSTRACT

OBJECTIVE: To examine the potential of LACE+ scores, in patients undergoing urologic surgery, to predict short-term undesirable outcomes. METHODS: Coarsened exact matching was used to assess the predictive value of the LACE+ index among all urologic surgery cases over a 2-year period (2016-2018) at 1 health system (n = 9824). Study subjects were matched on characteristics not assessed by LACE+, including duration of surgery and race, among others. For comparison of outcomes, matched populations were compared by LACE+ quartile with Q4 as the referent group: Q4 vs Q1, Q4 vs Q2, Q4 vs Q3. RESULTS: Seven hundred and twenty-two patients were matched for Q1-Q4; 1120 patients were matched for Q2-Q4; 2550 patients were matched for Q3-Q4. Escalating LACE+ score significantly predicted increased readmission (2.86% vs 4.91% for Q2 vs Q4; P = .012) and Emergency Room (ER) visits at 30 days postop (5.69% vs 11.37% for Q1 vs Q4, 4.11% vs 11.45% for Q2 vs Q4, 8.29% vs 13.32% for Q3 vs Q4; P <.001 for all). Increasing LACE score did not predict reoperation within 30 days or rate of death over follow-up within 30 postoperative days. CONCLUSION: The results of this study suggest that the LACE+ index is suitable as a prediction model for important patient outcomes in a urologic surgery population including unanticipated readmission and ER evaluation.


Subject(s)
Emergency Service, Hospital , Patient Readmission , Postoperative Complications , Urologic Surgical Procedures , Adult , Aged , Clinical Decision Rules , Continuity of Patient Care/standards , Emergency Service, Hospital/economics , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Male , Medical Overuse/prevention & control , Middle Aged , Operative Time , Patient Readmission/economics , Patient Readmission/statistics & numerical data , Postoperative Complications/economics , Postoperative Complications/mortality , Postoperative Complications/therapy , Prognosis , Reoperation/statistics & numerical data , United States/epidemiology , Urologic Surgical Procedures/adverse effects , Urologic Surgical Procedures/statistics & numerical data
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