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Accuracy of RAPT Score in Predicting Discharge Disposition in Patients Undergoing Spine Surgery Within an Enhanced

Susanna D Howard1, Rachel Pessoa1, Lauren Costello2

  • 1Department of Neurosurgery.

Clinical Spine Surgery
|March 28, 2025
PubMed
Summary

The Risk Assessment and Prediction Tool (RAPT) score showed limited accuracy in predicting discharge for spine surgery patients in an Enhanced Recovery After Surgery (ERAS) program. Integrating RAPT into social work evaluations is feasible but requires refinement for better prediction.

Keywords:
RAPT scoreenhanced recovery after surgerysocial workspine surgery

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Area of Science:

  • Orthopedic Surgery
  • Healthcare Management
  • Patient Outcomes

Background:

  • The Risk Assessment and Prediction Tool (RAPT) is used for discharge disposition in spine surgery.
  • Its validation within Enhanced Recovery After Surgery (ERAS) programs is lacking.

Purpose of the Study:

  • To assess the accuracy of RAPT score-based discharge disposition predictions in spine surgery patients within an ERAS program.
  • To evaluate if RAPT-initiated preoperative referrals expedite home services.

Main Methods:

  • Retrospective cohort study of 408 spine surgery patients in an ERAS program.
  • Preoperative social work evaluation included RAPT score generation.
  • Comparison of predicted vs. actual discharge destinations and timing of home services.

Main Results:

  • 50.7% of patients had their discharge disposition accurately predicted by the RAPT score.
  • Patients with accurate predictions received home services slightly faster, but the difference was not statistically significant.
  • The integration of RAPT into social work evaluations was feasible.

Conclusions:

  • The RAPT score, in its traditional tiers, demonstrated limited accuracy for predicting discharge disposition in this ERAS spine surgery cohort.
  • While feasible, the RAPT score requires further refinement for improved predictive power in ERAS settings.