Canadian researchers have developed a simple tool to predict the probability that a patient discharged from hospital to the community will die or be unexpectedly readmitted within 30 days. The study could help identify patients who may benefit from closer monitoring and care, so that serious health problems can be prevented.
The tool was developed by a group of Canadian researchers who examined detailed medical records from 4,812 people discharged from 11 Ontario hospitals between 2002 and 2006 and found that four factors could predict the risk of death or readmission. They called the tool LACE to coincide with the factors, which are:
- Length of stay in hospital.
- Acuity of the admission (whether or not it was through the ED).
- Comorbidity of the patient (a score based on what chronic diseases the patient has).
- ER utilization (number of visits in the previous six months).
Each factor is assigned a number of points based on its value. When these points are added together, they form the total LACE score. People with a score of 0 had only a 2 percent risk of death or readmission, while people with a score of 19 (the highest) had a 44 percent risk. The researchers obtained similar results when testing the LACE tool using records from 1 million Ontario patients discharged between 2004 and 2008.
"Ontario hospitals provide exceptional care, but many patients still face serious health challenges in the weeks following a hospital discharge," said Dr. Carl van Walraven of the Ottawa Hospital Research Institute (OHRI), the University of Ottawa and the Institute for Clinical Evaluative Sciences (ICES). "This research is an important step toward identifying those who are most at risk, so that we can address their health problems earlier and prevent serious complications."
Source: Ottawa Hospital Research Institute, March 1, 2010
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