Performance of the LACE index to predict 30-day hospital readmissions in patients with chronic obstructive pulmonary disease

This study of 2,662 COPD patients employed a retrospective cohort design to assess the predictive accuracy of the LACE index, a tool used to predict 30-day readmissions and mortality. In this study, the primary outcomes were 1) readmission within 30 days and death during stay for the index COPD admission and 2) 30-day readmission treated as a single variable. The 30-day readmission rate in this group was 25.1%; 56% of these readmissions were also for COPD (the authors note this is higher than reported in some other studies). Analysis of the model showed that the LACE index was moderately predictive of both the aforementioned outcomes (i.e., while not highly predictive of COPD readmission, the tool performed better than chance). While not statistically significant, these researchers also found a trend toward 30-day readmissions increasing as length of stay decreased. The authors discuss their results in relation to other studies using the LACE and similar tools such as the PEARL.