• Eric Winter, Gregory Glauser, Ian F Caplan, Stephen Goodrich, Scott D McClintock, Stephen J Kovach, Joshua Fosnot, Joseph M Serletti, and Neil R Malhotra.
• Department of Neurosurgery, Hospital of the University of Pennsylvania, Silverstein Pavilion, 3400 Spruce St, 3rd Floor, Philadelphia, PA 19104. Email: NRM@uphs.upenn.edu.
• Am J Manag Care. 2020 Apr 1; 26 (4): e113-e120.

ObjectivesThis study used coarsened exact matching to assess the ability of the LACE+ index to predict adverse outcomes after plastic surgery.Study DesignTwo-year retrospective study (2016-2018).MethodsLACE+ scores were retrospectively calculated for all patients undergoing plastic surgery at a multicenter health system (N = 5744). Coarsened exact matching was performed to sort patient data before analysis. Outcomes including unplanned hospital readmission, emergency department visits, and reoperation were compared for patients in different LACE+ score quartiles (Q1, Q2, Q3, Q4).ResultsA total of 2970 patient procedures were matched during coarsened exact matching. Increased LACE+ score significantly predicted readmission within 90 days of discharge for Q4 versus Q1 (6.28% vs 1.91%; P = .003), Q4 versus Q2 (12.30% vs 5.56%; P <.001), and Q4 versus Q3 (13.84% vs 7.33%; P <.001). Increased LACE+ score also significantly predicted emergency department visits within 90 days for Q4 versus Q1 (9.29% vs 3.01%; P <.001), Q4 versus Q2 (11.31% vs 3.57%; P <.001), and Q4 versus Q3 (13.70% vs 8.48%; P = .003). Higher LACE+ score also significantly predicted secondary reoperation within 90 days for Q4 versus Q1 (3.83% vs 1.37%; P = .035), Q4 versus Q2 (5.95% vs 3.37%; P = .042), and Q4 versus Q3 (7.50% vs 3.26%; P <.001).ConclusionsThe results of this study demonstrate that the LACE+ index may be suitable as a prediction model for patient outcomes in a plastic surgery population.

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