LACE Index – Hospital Readmission Risk
Estimates 30-day risk of death or unplanned readmission for medical and surgical inpatients
For use by health professionals only. This tool does not replace clinical judgement, local readmission reduction pathways, or social/functional assessment. Not for patient self-use.
Enter patient details
LACE score: 0 / 19
Risk category: Not yet calculated
Interpretation: —
Enter the details above and click “Calculate LACE score” to see the result and interpretation.
Scoring (original LACE): Length of stay 1 day =1 point, 2=2, 3=3, 4–6=4, 7–13=5, ≥14=7; admission via ED =3 points; comorbidity: CCI 0–3 gives 0–3 points, CCI ≥4 gives 5 points; ED use: 1–4 visits give 1–4 points (4 max). Typical bands used in the literature: 0–4 = low risk, 5–9 = moderate risk, ≥10 = high risk – local thresholds may differ.
The LACE Index for Readmission is a clinical prediction tool that estimates the risk of death or unplanned hospital readmission within 30 days of discharge. It was developed by van Walraven and colleagues in 2010 using data from over 4,000 medical and surgical patients, and later validated in large administrative datasets.CMAJ+1
“LACE” is an acronym for its four components:
- L – Length of stay in days for the index admission
- A – Acuity of admission (whether the patient came in via the Emergency Department)
- C – Comorbidities, measured using the Charlson Comorbidity Index (CCI)
- E – Emergency department (ED) visits in the previous 6 months (excluding the visit leading to the current admission)PMC+2SpringerLink+2
Each component is converted into points. Longer hospital stays, acute (ED) admissions, higher comorbidity burden, and more recent ED visits all increase the score. The total LACE score ranges from 0 to 19, with higher scores indicating greater risk.Alberta Doctors+2Alberta Health Services+2 In the original study, patients with a score of 0 had an expected 30-day risk of death or urgent readmission of about 2%, rising progressively to over 40% at a score of 19.PMC+1
Many organisations now group LACE scores into risk bands, for example: 0–4 = low risk, 5–9 = moderate risk, ≥10 = high risk, though some use slightly different thresholds (e.g. 0–6 / 7–10 / ≥11).SpringerLink+2Alberta Doctors+2 The tool is commonly used on medical and surgical wards to flag high-risk patients who might benefit from more intensive discharge planning, early follow-up, or post-discharge support. However, its performance varies between populations, and studies show moderate discrimination, so it should be used to support, not replace, clinical judgement.PMC+3BMJ Open+3PLOS+3
