Clinical Documentation

LACE Readmission Risk Scale

This assessment identifies patients who are at risk for readmission or death within thirty days of discharge. It uses four parameters:

"L": the length of stay of the admission
"A": the acuity of the admission (emergency or elective)
"C": co-morbidities (the Charlson Co-Morbidity Index)
"E": the number of Emergency Department visits within the last 6 months

LACE scores range from 1 to 19:

0-4: Low probability of readmission or death within thirty days of discharge
5-9: Moderate probability of readmission or death within thirty days of discharge
≥10: High probability of readmission or death within thirty days of discharge

Length of Stay
	Days	Score
	1	1
	2	2
	3	3
	4-6	4
	7-13	5
	14+	7
Acuity of admission
		Score
	If patient was admitted via the ED	3
	If patient was not admitted via the ED	0
Comorbidities
		Score
	Previous MI	1
	Cerebrovascular disease	1
	Peripheral vascular disease	1
	Diabetes without complications	1
	Congestive heart failure	2
	Diabetes with end organ damage	2
	Chronic pulmonary disease	2
	Mild liver or renal disease	2
	Any tumor (including lymphoma or leukemia)	2
	Dementia	3
	Connective tissue disease	3
	AIDS	4
	Moderate or severe liver or renal disease	4
	Metastatic solid tumor	6
Emergency department visits	How many times the patient has visited an emergency department in the six months prior to admission (not including the emergency department visit immediately preceding the current admission)	Score is this number or 4, whichever is smaller.
Calculation
	Total
	0-4	Low probability of readmission or death within thirty days of discharge
	5-9	Moderate probability of readmission or death within thirty days of discharge
	≥10	High probability of readmission or death within thirty days of discharge

Here is the original publication of LACE: Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community in CMAJ

Carl van Walraven, Irfan A. Dhalla, Chaim Bell, Edward Etchells, Ian G. Stiell, Kelly Zarnke, Peter C. Austin and Alan J. Forster, CMAJ April 06, 2010 182 (6) 551-557; DOI: https://doi.org/10.1503/cmaj.091117

Here are the documents describing LOINC's implementation:

96569-9_LACE Index_LOINC detail pages_20210331.pdf
CompletedTermReport_5617_LACE index.xlsx
LACE tool_LOINCs added.doc