Use of The Risk Assessment and Prediction Tool to Predict Same-day Discharge After Primary Hip and Knee Arthroplasty.

Marcel M Dupont, Michael B Held, Roshan P Shah, H John Cooper, Alexander L Neuwirth, Thomas R Hickernell
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Abstract

Introduction: The Risk Assessment and Prediction Tool (RAPT) is a preoperative screening tool developed to predict discharge disposition after total hip arthroplasty (THA) and total knee arthroplasty (TKA), but its predictive value for same-day discharge (SDD) has not been investigated. The aims of this study were (1) to assess RAPT's ability to predict SDD after primary THA and TKA and (2) to determine a cutoff RAPT score that may recognize patients appropriate for SDD.

Methods: Data were retrospectively collected from patients undergoing primary THA and TKA at a single tertiary care center between February 2020 and May 2021. A receiver operating characteristic curve was generated to choose a cutoff value to screen for SDD. Logistic regression analysis was done to identify factors including age, BMI, or RAPT score that may be associated with SDD.

Results: Three hundred sixty-one patients with preoperative RAPT scores were included in the analysis of whom 147 (42.6%) underwent SDD. A cutoff of ≥9 was identified for TKA and ≥11 for THA. RAPT had a predictive accuracy of only 66.7% for SDD, whereas the discharge plan documented in the preoperative note was 91.7% accurate.

Discussion: Although there is a positive association between RAPT and SDD, it is not a useful screening tool given its low predictive accuracy.

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使用风险评估和预测工具预测初次髋关节和膝关节置换术后当天出院情况。
导言:风险评估和预测工具 (RAPT) 是一种术前筛查工具,用于预测全髋关节置换术 (THA) 和全膝关节置换术 (TKA) 后的出院处置,但其对当日出院 (SDD) 的预测价值尚未得到研究。本研究的目的是:(1) 评估 RAPT 预测初次 THA 和 TKA 术后 SDD 的能力;(2) 确定可识别适合 SDD 患者的 RAPT 临界分数:回顾性收集了2020年2月至2021年5月期间在一家三级医疗中心接受初级THA和TKA手术患者的数据。生成接收者操作特征曲线,以选择筛查 SDD 的临界值。进行了逻辑回归分析,以确定可能与 SDD 相关的因素,包括年龄、体重指数或 RAPT 评分:分析纳入了361名术前有RAPT评分的患者,其中147人(42.6%)接受了SDD。TKA的临界值为≥9分,THA的临界值为≥11分。RAPT对SDD的预测准确率仅为66.7%,而术前病历中记录的出院计划的准确率为91.7%:讨论:尽管RAPT与SDD之间存在正相关,但由于其预测准确性较低,因此并非有用的筛查工具。
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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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