Hepatopancreatobiliary readmission score out performs administrative LACE+ index as a predictive tool of readmission.

Abstract

BACKGROUND\nThis study aims to compare the LACE\xa0+\xa0readmission index to a novel hepatopancreatobiliary readmission risk score (HRRS) in predicting post-operative hepatopancreatobiliary (HPB) cancer patient readmissions.\n\n\nMETHODS\nA retrospective review of 104 postoperative HPB cancer patients from January 2017 to July of 2019 was performed. Univariable and multivariable analyses were utilized.\n\n\nRESULTS\nThe LACE\xa0+\xa0index did not predict 30-day (OR 1.01, 95% CI, 0.97-1.05, p\xa0=\xa00.81, c-statistic\xa0=\xa00.52) or 90-day (OR 1.02, 95% CI, 0.98-1.05, p\xa0=\xa00.43) readmission. Patients readmitted within 30 days had significantly increased HRRS scores compared to those who were not (0 vs 34, p\xa0<\xa00.001). A single unit increase in HRRS corresponded to a 6.5% increased risk of readmission; (OR 1.065, 95% CI, 1.038-1.094, p\xa0<\xa00.0001). HRRS independently predicted 30-day (OR 1.07, 95% CI, 1.04-1.11, p\xa0<\xa00.0001) and 90-day postoperative readmission (OR 1.05, 95% CI 1.03-1.08, p\xa0<\xa00.0001).\n\n\nCONCLUSIONS\nHRRS better predicts postoperative readmissions for HPB surgical patients compared to LACE+. Accurate assessment of postoperative readmission must include readmission scores focused on clinically relevant perioperative parameters.