For healthcare professionals
LACE index calculator
The LACE index ranks the risk of death or unplanned readmission within 30 days of leaving hospital, from four items known at discharge. This tool is written for clinicians planning discharge and follow-up. It is not a self-check and not a diagnosis.
Findings at discharge
For an adult being discharged from hospital. Nothing you enter leaves this page.
Need the score? Use the Charlson comorbidity index calculator.
What you will see
The LACE index from 0 to 19, the points for each item and whether the total reaches the high risk mark of 10.
Educational only, not medical advice. A score never replaces the judgment of the treating team.
Source
The LACE index by van Walraven and colleagues, CMAJ 2010, with the items and points as printed in Table 2 of the open access study by Robinson and Hudali, PeerJ 2017 (CC BY 4.0), checked band by band against the table in Tokac and colleagues, World Journal of Surgery 2025 (CC BY 4.0). The high risk mark of 10 or more is the one used in both open studies. The tests check every band edge, the maximum of 19 and the high risk mark.
Validated in
The index was built to predict death or unplanned readmission within 30 days of discharge from hospital to the community in adults. We cite the 2010 paper but do not quote it, because its license does not allow reuse here. Robinson and Hudali tested it for readmission in 432 discharges from a medical hospitalist service at a community hospital in the United States. Tokac and colleagues tested it in trauma and general surgery records at a hospital in South Africa.
Limits
For adults leaving hospital, not for pediatric or obstetric stays. The index gives a rank, not a percentage for one patient, and how well it separates patients differs a lot between hospitals and patient groups. A stay of less than 1 day is entered as 0. Studies count the Charlson score in different ways (Tokac and colleagues used a version that includes age), so use the version your team works with. Visits counted are emergency department visits in the 6 months before the admission.
The point table
LACE index, as printed in Robinson and Hudali 2017 (Robinson 2017) (van Walraven 2010), with the same points in Tokac 2025 (Tokac 2025):
- Length of stay: less than 1 day 0, 1 day 1, 2 days 2, 3 days 3, 4 to 6 days 4, 7 to 13 days 5, 14 days or more 7
- Acute or emergent admission: 3
- Charlson comorbidity index score: 0 scores 0, 1 scores 1, 2 scores 2, 3 scores 3, 4 or more scores 5
- Emergency department visits in the previous 6 months: 0 scores 0, 1 scores 1, 2 scores 2, 3 scores 3, 4 or more scores 4
The total ranges from 0 to 19. Worked example: a patient admitted through the emergency department (3) who stays 5 days (4), with a Charlson score of 2 (2) and 1 emergency department visit in the previous 6 months (1) scores 10, the high risk range.
Reading the result
Robinson and Hudali labelled a LACE index of 10 or more as high risk (Robinson 2017), and Tokac and colleagues describe the total as ranging from 0 to 19, with 10 and above indicating higher risk of readmission (Tokac 2025). Neither study gives a readmission percentage for each score.
In Robinson and Hudali's cohort, 35 of 432 discharges (8%) were readmitted to the same hospital within 30 days. The LACE index had a C statistic of 0.58, which the authors call poor discrimination, against 0.75 for the HOSPITAL score in the same patients (Robinson 2017). In Tokac and colleagues' study, 804 unplanned readmissions were recorded among 15,354 trauma surgery records and 2,192 among 21,994 general surgery records. A score of 10 or more had a sensitivity of 13.81% and a specificity of 91.63% in trauma surgery, and a sensitivity of 44.80% and a specificity of 71.47% in general surgery (Tokac 2025). The authors found the index better at picking out patients who were less likely to be readmitted than those at higher risk (Tokac 2025).
A high score points to patients who may benefit most from careful discharge planning and early follow-up; it does not say which patient will come back.
Related tools
For a second readmission score built for medical wards, see the HOSPITAL score. For the comorbidity item, use the Charlson comorbidity index. For frailty in older adults, see the FRAIL scale. Other bedside scores are listed under For healthcare professionals.
Sources
- Robinson R, Hudali T. The HOSPITAL score and LACE index as predictors of 30 day readmission in a retrospective study at a university-affiliated community hospital. PeerJ. 2017;5:e3137. doi:10.7717/peerj.3137. PMID 28367375. Open access (CC BY 4.0). pmc.ncbi.nlm.nih.gov/articles/PMC5374974/
- Tokac U, Chipps J, Brysiewicz P, Bruce J, Clarke D. Using natural language processing in the LACE index scoring tool to predict unplanned trauma and surgical readmissions in South Africa. World J Surg. 2025;49(4):1067-1073. doi:10.1002/wjs.12523. PMID 40059292. Open access (CC BY 4.0). pmc.ncbi.nlm.nih.gov/articles/PMC11994145/
- van Walraven C, Dhalla IA, Bell C, et al. Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. CMAJ. 2010;182(6):551-557. doi:10.1503/cmaj.091117. PMID 20194559. doi.org/10.1503/cmaj.091117
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-03. Spotted an error? See About.