Derivation and Validation of a Scoring System to Predict LAAC Readmissions
A simple scoring system was devised based on non-routine disposition and the presence of chronic pulmonary disease, peripheral vascular disease, chronic kidney disease/end stage renal disease and anemia. Non-routine disposition, chronic pulmonary disease and renal disease were assigned 2 points each, while peripheral vascular disease and anemia were given 1 point each (Figure 4). In the derivation cohort, the scoring system had a stepwise discriminatory ability in predicting readmission. For example, patients with a score of 1 had a readmission rate of 4.2%,
while a score of 5 or more had a readmission rate of 23.1% (Figure 5). The C-statistic for the scoring system for the derivation cohort was 0.6787.
Figure 4. Multivariable model of 30-day readmissions in patients undergoing LAAC procedures with scoring system integrated. Parentheses indicate 95% confidence intervals.
Figure 5. Readmission scoring model correlating likelihood of readmission within 30 days with numerical score using the derivation cohort.
This scoring system was applied to the 2014-2015 NRD using the ICD-9 codes for the risk factors noted above. The scoring system maintained predictive ability and is represented in Figure 6. The C-statistic in the validation cohort was 0.633.
Figure 6. Readmission scoring model correlating likelihood of readmission within 30 days with numerical score using the validation cohort.