The role of LACE index in predicting 30-day unplanned readmission in patients receiving immunotherapy

BackgroundThe aim of this study was to investigate the LACE index to predict the risk of 30-day unplanned hospital readmission in patients receiving immunotherapy. Since hospitalisation is a common and costly condition, we evaluated this score in non-small cell metastatic lung cancer patients receiving immunotherapy.MethodsBetween January 2020 and December 2023, 157 patients with metastatic non-small cell lung cancer receiving immunotherapy in our center were screened. Patients who died during hospitalisation, patients admitted for chemotherapy and day care procedures, and subsequent hospitalisation within a month were excluded. LACE index model includes the length of hospitalization stay (L), acuity of the admission (A), comorbidities of patients (C), and the number of emergency department visits in the six months before admission (E). LACE index scores of the patients were calculated according to this model.ResultsA total of 72 metastatic non-small cell lung cancer patients hospitalised in our oncology inpatient clinic were included in the study. Thirty-five (48.6%) of the patients were over 65 years of age. Most of the patients had lung adenocarcinoma (n:49, 68.1%). Twenty-one (29.2%) patients had cranial metastases. Forty-four (61.1%) patients were hospitalised for palliative care and 28 (38.9%) were hospitalized due to infection. The median hospital stay of the patients was four days (min-max: 1- 30). The median LACE score of the patients was 11 (min-max: 6-16). Fourty-six (% 63.9) patients had a high LACE score, twenty-six were in the moderate group. Thirty (65.2%) of 46 patients with high LACE scores were readmitted to the hospital within 30 days. This rate was statistically significantly higher (p: 0.028) than the moderate group (n=10, 38.5%). While 45.7% of the patient group with a high LACE score died within 90 days, this rate was (26.9%) in the moderate patient group (p: 0.11).ConclusionsThe LACE index predicted one-month readmission in oncology patients receiving immunotherapy but was insufficient to predict death within 90 days. It can be considered as an easy-to-use index in patients receiving immunotherapy to predict readmission.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.