Prediction value of the LACE index to identify older adults at high risk for all-cause mortality in South Korea: a nationwide population-based study

Eunbyul Cho, Sumi Lee, Woo Kyung Bae, Jae ryun Lee, Hyejin Lee

Research output: Contribution to journalArticlepeer-review

Abstract

Background: As a tool to predict early hospital readmission, little is known about the association between LACE index and all-cause mortality in older adults. We aimed to validate the LACE index to predict all-cause mortality in older adults and also analyzed the LACE index outcome of all-cause mortality depending on the disease and age of the participants. Methods: We used the National Health Insurance Service (NHIS) cohort, a nationwide claims database of Koreans. We enrolled 7491 patients who were hospitalized at least once between 2003 and 2004, aged ≥65 years as of the year of discharge, and subsequently followed-up until 2015. We estimated the LACE index using the NHI database. The Cox proportional hazards model was used to estimate the hazard ratio (HR) for all-cause mortality. Furthermore, we investigated all-cause mortality according to age and underlying disease when the LACE index was ≥10 and < 10, respectively. Results: In populations over 65 years of age, patients with LACE index ≥10 had significantly higher risks of all-cause mortality than in those with LACE index < 10. (HR, 1.44; 95% confidence interval, 1.35–1.54). For those patients aged 65–74 years, the HR of all-cause mortality was found to be higher in patients with LACE index≥10 than in those with LACE index < 10 in almost all the diseases except CRF and mental illnesses. And those patients aged ≥75 years, the HR of all- cause mortality was found to be higher in patients with LACE index ≥10 than in those with LACE index < 10 in the diseases of pneumonia and MACE. Conclusion: This is the first study to validate the predictive power of the LACE index to identify older adults at high risk for all-cause mortality using nationwide cohort data. Our findings have policy implications for selecting or managing patients who need post-discharge management.

Original languageEnglish
Article number154
JournalBMC geriatrics
Volume22
Issue number1
DOIs
StatePublished - Dec 2022
Externally publishedYes

Keywords

  • All-cause mortality
  • LACE index
  • Nationwide database
  • Older adults

Fingerprint

Dive into the research topics of 'Prediction value of the LACE index to identify older adults at high risk for all-cause mortality in South Korea: a nationwide population-based study'. Together they form a unique fingerprint.

Cite this