Physical medicine and rehabilitation (PM&R) department, hôpital Nord, CHU de Clermont-Ferrand, route de Chateaugay, BP 30056, 63118 Cébazat, France.
Département de médecine générale, faculté de médecine, université d'Auvergne, 63000 Clermont-Ferrand, France.
Ann Phys Rehabil Med. 2014 Apr;57(3):169-84. doi: 10.1016/j.rehab.2014.02.002. Epub 2014 Mar 24.
To assess the relevance of the RAPT (Risk Assessment and Prediction Tool), among a cohort of patients undergoing total hip arthroplasty (THA).
Prospective study of a cohort of patients evaluated before and after THA. The difference between the postoperative orientation predicted by the RAPT and the real one is assessed. Clinical, environmental and psychosocial criteria that could significantly change the orientation are discussed.
One hundred and thirty-four patients (94 women and 40 men) were included. The average age was 71.6 (±10) years. Primary hip osteoarthritis was the indication for surgery in 78% of cases. The average length of stay in the surgery ward was 10 (±3) days. It was significantly higher for patients referred to a rehabilitation ward (P<0.0001). Sixty-six percent of patients were referred to a rehabilitation ward and 34% returned directly home. The average length of stay in rehabilitation ward was 27 (±13) days. The validity of the RAPT as a help decision tool has been confirmed. Thus, a low RAPT score was significantly associated with more frequent referral to a rehabilitation ward, conversely, a high RAPT score is significantly related to more frequent direct return to home.
This study confirmed the usefulness of the RAPT to help in patient orientation decision after total hip arthroplasty. The patient preference remains the main variable for orientation after THA. By the way, the patient preference must not be integrated into the RAPT, but need to be collected and be discussed with the patient.
评估 RAPT（风险评估和预测工具）在全髋关节置换术（THA）患者队列中的相关性。
对接受 THA 前后的患者队列进行前瞻性研究。评估 RAPT 预测的术后定向与实际定向之间的差异。讨论可能显著改变定向的临床、环境和社会心理标准。
共纳入 134 例患者（94 名女性和 40 名男性），平均年龄为 71.6（±10）岁。原发性髋骨关节炎是 78%手术适应证的患者。手术病房的平均住院时间为 10（±3）天。对于转往康复病房的患者，这一数字显著更高（P<0.0001）。66%的患者被转往康复病房，34%的患者直接回家。康复病房的平均住院时间为 27（±13）天。RAPT 作为决策辅助工具的有效性已得到证实。因此，低 RAPT 评分与更频繁地转往康复病房显著相关，相反，高 RAPT 评分与更频繁地直接返回家中显著相关。
本研究证实了 RAPT 在全髋关节置换术后帮助患者定向决策的有用性。患者的偏好仍然是 THA 后定向的主要变量。无论如何，患者的偏好不应纳入 RAPT，而需要收集并与患者讨论。
