RAPT and AM-PAC "6-Clicks": Do They Correlate on Predicting Discharge Destination After Total Joint Arthroplasty?

Area of Science:

• Orthopedic Surgery
• Rehabilitation Medicine
• Health Services Research

Background:

• Validated discharge planning tools for total hip arthroplasty (THA) and total knee arthroplasty (TKA) include the Risk Assessment and Prediction Tool (RAPT) and the Activity Measure for Post-Acute Care "6-Clicks" Mobility Score (AM-PAC).
• These tools assess different factors, necessitating an examination of their relationship in predicting patient discharge destinations.

Purpose of the Study:

• To determine the correlation between preoperative RAPT scores and postoperative AM-PAC scores in predicting discharge destination for THA and TKA patients.
• To assess if RAPT and AM-PAC scores remain significant predictors of discharge destination when controlling for covariates.

Main Methods:

• A retrospective cohort study of THA and TKA patients (January 2020 - December 2022) at an orthopedic specialty hospital.
• Primary variables included RAPT score, AM-PAC score, and discharge disposition.
• Statistical analyses involved Pearson's correlation coefficient, chi-square tests, and multivariable logistic regression.

Main Results:

• A statistically significant positive correlation was observed between RAPT and AM-PAC scores in both THA and TKA cohorts.
• Both RAPT and AM-PAC scores were significant predictors of discharge home, even after adjusting for covariates.
• Factors associated with facility discharge included female sex, age over 70, Medicare/Medicaid insurance, increased social work visits, and intraoperative/hospital complications.

Conclusions:

• The RAPT score correlates with the AM-PAC score in predicting discharge destination for elective THA and TKA patients.
• These scores may serve as reliable predictors of home discharge, even when considering other patient factors.
• Further research is recommended to validate these findings and explore their clinical utility.