Accuracy of RAPT Score in Predicting Discharge Disposition in Patients Undergoing Spine Surgery Within an Enhanced Recovery After Surgery Program.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-03-28 DOI:10.1097/BSD.0000000000001810

Susanna D Howard, Rachel Pessoa, Lauren Costello, Menekse Silpagar, Diana Gardiner, Ujwala Tambe, Scott Rushanan, Disha Joshi, Jessica Nguyen, Dominick Macaluso, Neil R Malhotra, William Welch, Zarina S Ali

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引用次数: 0

Abstract

Study design: This is a retrospective cohort study.

Objective: The primary objective was to determine the accuracy of the Risk Assessment and Prediction Tool (RAPT) score-based discharge disposition prediction among patients undergoing spine surgery within an Enha Recovery After Surgery (ERAS) program. The secondary objective was to determine if using RAPT to initiate preoperative referrals to home services expedited care.

Summary of background data: The RAPT score has been applied to spine surgery patients but has not been validated among participants in an ERAS program.

Methods: All patients undergoing elective spine surgery within an ERAS program over a 1-year period received a preoperative social work evaluation incorporating the generation of RAPT score. Patients predicted to be discharged home with services received a preoperative referral for home services. The predicted versus actual discharge destination was compared, and the association of preoperative home services referral with the timing of home services initiation was assessed.

Results: Four hundred eight patients received a preoperative social work evaluation with RAPT score calculation. Two hundred seven (50.7%) patients had an accurately predicted postoperative discharge disposition based on RAPT score. Among the patients who received home services following discharge, the mean time to receipt of home services was shorter among patients who had a correct discharge disposition prediction compared with patients who had an incorrect prediction, but this difference was not statistically significant [31.3 (SD: 15.6) vs. 42.0 h (SD: 44.2), P=0.24].

Conclusions: This study supports the feasibility of integrating RAPT score calculation into a preoperative social work evaluation. However, the traditional tiers of RAPT scores had limited accuracy in predicting discharge disposition in this cohort of patients undergoing spine surgery within an ERAS program.

Level of evidence: Level III.

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.