Readmission and Mortality in Trauma Patients Utilizing LACE Index

BackgroundTrauma patients are sometimes readmitted unexpectedly soon after discharge from index admission. LACE Index measures four variables (Length of stay, Acuity of admission, Comorbidity, and prior Emergency department visits within 6 months) that are independently associated with death or readmission within 30 days of discharge from hospitalization. Our Trauma Center began utilizing LACE scores to schedule follow-ups for patients discharged home with LACE scores ≥7. We sought to determine factors related to trauma patient readmission and mortality and evaluate the impact of LACE follow-up appointments on 30-day readmission and mortality. We hypothesized that instituting LACE follow-ups would reduce readmissions and mortality.MethodsWe performed a retrospective review (1/1/21-6/30/22 and 7/1/22-12/31/23) evaluating readmission in trauma patients ≥18y before LACE (BL) and during LACE (DL) follow-up appointments. Univariate and multivariable analyses were conducted. A <i>P</i>-value <.05 was considered significant.Results1788 patients were included: 872 BL and 914 DL. Readmission was slightly higher DL vs BL and mortality was lower DL vs BL. Multivariable analysis showed patients with cirrhosis had an increased risk of readmission and patients with commercial insurance had a decreased risk of readmission. Multivariable analysis showed attending a follow-up did not impact risk of readmission but decreased risk of mortality.ConclusionOur data partially supported our hypothesis; attending an LACE follow-up decreased 30-day mortality but not readmission. Further investigation is warranted to validate the threshold of LACE score that will help prevent readmission and mortality in trauma patients.