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July 4, 2026BMC Health Services ResearchOpen Access

LACE index and HOSPITAL scores demonstrate fair discrimination for predicting 30-day readmissions.

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Why the study?

Do the LACE index and HOSPITAL score predict 30-day readmissions in adult internal medicine patients in a lower-middle-income country?

Population

35,496 adult patients admitted to the internal medicine service at a tertiary care hospital in Karachi…

Design

Cohort

Follow-up

30 days

Key result

The LACE index and HOSPITAL scores demonstrated fair discrimination for predicting 30-day readmissions, with AUCs of 0.670 (95% CI 0.65-0.69) and 0.655 (95% CI 0.63-0.67), respectively.

Authors

MAManzar AbbasHAHajra ArshadMMMuhammad Umar Mahar

Discussion

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Overview

LACE/HOSPITAL scores may support discharge risk stratification; leaves open whether routine use improves outcomes or reduces readmissions.

Key Points

  • This study aims to evaluate the effectiveness of the LACE index and HOSPITAL score in predicting 30-day readmissions.
  • Retrospective cohort study involving 35,496 patients aged 18 and above admitted to an internal medicine service.
  • Data collection spanned five years (2016-2020) at a tertiary care hospital in Karachi, Pakistan.
  • Readmission rates and predictive scores were analyzed, including ROC curve evaluations.
  • 8.0% of patients (2,822) were readmitted within 30 days.
  • Patients readmitted had a higher mean LACE index (8.9 vs. 7.4, p<0.001) and HOSPITAL score (3.4 vs. 2.6, p<0.001).
  • ROC curve showed AUC of 0.670 for LACE index and 0.655 for HOSPITAL score, indicating fair predictive ability.

Study Design

Type

Cohort (n=35,496)

Multicenter

No

Structured PICO

Do the LACE index and HOSPITAL score predict 30-day readmissions in adult internal medicine patients in a lower-middle-income country?

P
Population
35,496 adult patients (mean age 55.3 years, 46.6% female) admitted to an internal medicine service at a tertiary care hospital in Pakistan, evaluated for 30-day readmission.
E
Exposure
LACE index and HOSPITAL score
O
Outcome
30-day readmission

Main Result

Effect estimate: AUC 0.670 (LACE) and 0.655 (HOSPITAL) (95% CI 0.65-0.69 (LACE); 0.63-0.67 (HOSPITAL))

Both the LACE index and HOSPITAL score demonstrated fair and comparable discrimination for predicting 30-day readmissions in an internal medicine cohort in a lower-middle-income country.

Cite This Study

Abbas et al. (2026) conducted a cohort in Internal medicine admissions (n=35,496). LACE index and HOSPITAL score was evaluated on 30-day readmission (AUC 0.670 (LACE) and 0.655 (HOSPITAL), 95% CI 0.65-0.69 (LACE); 0.63-0.67 (HOSPITAL)). The LACE index and HOSPITAL scores demonstrated fair discrimination for predicting 30-day readmissions, with AUCs of 0.670 (95% CI 0.65-0.69) and 0.655 (95% CI 0.63-0.67), respectively.

synapsesocial.com/papers/6a48aaf789561a0c2d78f098https://doi.org/10.1186/s12913-026-15070-4
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