Alshahwani Awf A, Dungey Maurice, Lillie Christopher, Krikler Steve, Plakogiannis Christos
Trauma and Orthopaedics, Leicester University Hospital, Leicester, GBR.
Trauma and Orthopaedics, Kettering General Hospital, Kettering, GBR.
Cureus. 2021 Mar 25;13(3):e14112. doi: 10.7759/cureus.14112.
The Risk Assessment and Prediction Tool (RAPT) was developed to predict patient discharge destination for arthroplasty operations. However, since Enhanced Recovery After Surgery (ERAS) programs have been utilized in the UK, the RAPT score has not been validated for use. The aim of the current study was to evaluate the predictive validity of the RAPT score in an ERAS environment with short length of stay. Data were compiled from 545 patients receiving a primary elective total hip or total knee arthroplasty in a district general hospital over 12 months. RAPT scores, length of stay, and discharge destinations were recorded. Patients were classified as low, intermediate, or high risk as per their RAPT score. Length of stay was significantly different between groups (p = 0.008), with low-risk patients having shorter length of stay. However, RAPT scores did not predict discharge destination; the overall correct prediction was only 31.9%. Furthermore, the most likely discharge destination was directly home in ≤3 days in all groups (68.5%, 60.2%, and 40% for the low-, intermediate-, and high-risk groups, respectively). The RAPT score is not an adequate tool to predict the discharge disposition following primary total knee and hip replacement surgery in a UK hospital with a standardized modern ERAS program. Alternative predictive tools are required.
风险评估与预测工具（RAPT）旨在预测关节置换手术患者的出院去向。然而，自英国采用加速康复外科（ERAS）计划以来，RAPT评分尚未得到验证可用于此。本研究的目的是评估在住院时间较短的ERAS环境中RAPT评分的预测有效性。数据收集自一家地区综合医院在12个月内接受初次择期全髋关节或全膝关节置换术的545例患者。记录RAPT评分、住院时间和出院去向。根据RAPT评分将患者分为低、中、高风险组。各组之间的住院时间有显著差异（p = 0.008），低风险患者的住院时间较短。然而，RAPT评分并不能预测出院去向；总体正确预测率仅为31.9%。此外，所有组中最可能的出院去向是在≤3天内直接回家（低、中、高风险组分别为68.5%、60.2%和40%）。在一家采用标准化现代ERAS计划的英国医院中，RAPT评分并非预测初次全膝关节和髋关节置换术后出院处置的充分工具。需要其他预测工具。
