Italian Version of the Risk Assessment and Prediction Tool: Properties and Usefulness of a Decision-Making Tool for Subjects’ Discharge after Total Hip and Knee Arthroplasty

Background : Growing attention is being given to standardized outcome measures to improve interventions for total hip arthroplasty (THA) and total knee arthroplasty (TKA). We culturally adapt and validate the Italian version of the Risk Assessment and Prediction Tool (RAPT-I) to allow its predictive use after THA and TKA. Methods : The RAPT-I was adapted by forward–backward translation, a final review by an expert committee and a test of the pre-final version to establish its correspondence with the original version. The psychometric testing included test–retest reliability (intraclass correlation coefficient, ICC). The RAPT score was used to predict the subjects’ destination ( 9: discharge directly at home) by comparing the actual discharge destination with the predicted destination. The predictive effects of RAPT items on the discharge destination were further described by a logistic regression model (repeated leave-one-out bootstrap procedure). Results : The questionnaire was administered to 78 subjects with THA and 70 subjects with TKA and proven to be acceptable. The questionnaire showed excellent test–retest reliability (ICC = 0.839; with 95% confidence interval (CI) of 0.725–0.934 for THA; ICC = 0.973, with 95% CI of 0.930–0.997 for TKA). The RAPT-I overall predictive validity was 87.2%, and the discharge destination was directly related to living condition (odds ratio (OR) = 2.530), mobility (OR = 2.626) and age (OR = 1.332) and inversely related to gait aids (OR = 0.623) and gender (OR = 0.474). Conclusions : The RAPT-I was successfully adapted into Italian and proven to exhibit satisfactory properties, including predictive validity in determining discharge destination.