Matched analysis of the LACE+ score for post-operative outcomes in patients with intradural spinal tumors

Abstract

Objective The management of intradural spinal tumors can be complex and associated with high resource utilization. The LACE+ index is a validated tool developed to predict post-operative readmission and mortality. This study evaluated the utility of LACE+ in patients undergoing surgery for intradural spinal tumors.Methods Data on patients undergoing spinal oncology surgery for intradural tumors (n = 275) with LACE+ score was collected. Coarsened exact matching was used to control for confounding variables and assess the predictive value of LACE+. Patients with a LACE+ score in the top quartile (≥ 58, n = 18) were compared to matched patients in the bottom quartile (≤23, n = 18). A secondary analysis compared the top (> 44, n = 58) and bottom (≤ 44, n = 58) halves. Outcomes included 30- and 90-day ED visits, readmissions, reoperations, non-home discharges, and mortality.Results After matching, patients in the top LACE+ quartile had greater odds of non-home discharge (OR 5.80, p = 0.02) and 90-day readmission (OR 5.52, p = 0.04). In the secondary analysis, patients in the top half had greater odds of non-home discharge (OR 2.5, p = 0.04).Conclusions Higher LACE+ scores were associated with non-home discharge and 90-day readmission after intradural spinal tumor surgery. Application of this tool may guide risk stratification and perioperative management of patients.