Original Research Article| Volume 223, ISSUE 5, P933-938, May 2022

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

Published:September 30, 2021DOI:


      • LACE + readmission index fails to accurately predict readmission in an HPB patient population.
      • Hepatopancreatobiliary readmission risk score independently predicts readmission.
      • Use of clinically relevant readmission risk calculators is warranted in postoperative patients.



      This study aims to compare the LACE + readmission index to a novel hepatopancreatobiliary readmission risk score (HRRS) in predicting post-operative hepatopancreatobiliary (HPB) cancer patient readmissions.


      A retrospective review of 104 postoperative HPB cancer patients from January 2017 to July of 2019 was performed. Univariable and multivariable analyses were utilized.


      The LACE + index did not predict 30-day (OR 1.01, 95% CI, 0.97–1.05, p = 0.81, c-statistic = 0.52) or 90-day (OR 1.02, 95% CI, 0.98–1.05, p = 0.43) readmission. Patients readmitted within 30 days had significantly increased HRRS scores compared to those who were not (0 vs 34, p < 0.001). 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 < 0.0001). HRRS independently predicted 30-day (OR 1.07, 95% CI, 1.04–1.11, p < 0.0001) and 90-day postoperative readmission (OR 1.05, 95% CI 1.03–1.08, p < 0.0001).


      HRRS 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.


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