Transcultural validation of the Risk Assessment and Predictor Tool (RAPT) to predict discharge outcomes after total...

Area of Science:

• Orthopedics
• Geriatric Medicine
• Rehabilitation Science

Background:

• Total hip arthroplasty (THA) necessitates accurate postoperative patient disposition planning.
• The Risk Assessment and Prediction Tool (RAPT) was developed to aid in this decision-making process.
• Assessing the RAPT's predictive validity in a real-world THA cohort is crucial for optimizing patient care pathways.

Purpose of the Study:

• To evaluate the clinical relevance and predictive accuracy of the RAPT in patients undergoing THA.
• To determine if the RAPT score correlates with actual postoperative patient orientation (discharge destination).
• To identify factors influencing patient disposition post-THA and their relationship with RAPT predictions.

Main Methods:

• A prospective study design involving a cohort of 134 patients undergoing THA.
• Preoperative RAPT assessment and comparison with actual postoperative discharge destinations (rehabilitation ward vs. direct home).
• Analysis of clinical, environmental, and psychosocial factors potentially affecting patient orientation.

Main Results:

• The RAPT demonstrated validity in predicting discharge destination; low scores correlated with rehabilitation referrals, high scores with direct home discharge.
• A significant association was found between RAPT scores and disposition, confirming its utility as a decision-support tool.
• Patient preference emerged as a significant factor in orientation, independent of RAPT prediction.

Conclusions:

• The RAPT is a useful tool for guiding patient orientation decisions after THA.
• While the RAPT is valuable, patient preference is the primary driver for discharge disposition.
• Patient preference should be collected and discussed alongside RAPT scores, but not integrated into the tool itself.