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Matched Analysis of the Risk Assessment and Prediction Tool for Post-Operative Disposition Needs in a Spinal Oncology
Emily Xu1, Ritesh Karsalia1, Jason Kost2
1Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA.
Global Spine Journal
|February 10, 2026
Summary
The Risk Assessment and Prediction Tool (RAPT) effectively predicts post-acute care needs for spinal cancer surgery patients. Low RAPT scores indicate a higher likelihood of non-home discharge and readmission, aiding resource allocation.
Area of Science:
- Oncology
- Surgical Outcomes
- Healthcare Management
Background:
- Metastatic spinal cancer is increasingly common with improved cancer survival.
- Optimizing perioperative planning is crucial due to high resource demands in spinal oncology care.
Purpose of the Study:
- To evaluate the Risk Assessment and Prediction Tool (RAPT) for predicting post-operative needs in spinal tumor surgery patients.
- To assess RAPT's effectiveness in identifying patients requiring post-acute care.
Main Methods:
- Retrospective cohort study of 384 spinal oncology surgery patients prospectively assessed with RAPT.
- Coarsened exact matching (CEM) to compare low (≤9) and high (10-12) RAPT score groups (n=44 each).
- Primary outcome: post-acute care disposition; Secondary outcomes: 30/90-day ED visits, readmissions, reoperations.
Main Results:
- Low RAPT scores significantly predicted non-home discharge (OR=4.33) and 30-day readmission (OR=3.66).
- 31.8% of low-scoring patients required post-acute care versus 11.3% of high-scoring patients.
- The RAPT walk score alone predicted non-home discharge (OR=2.8).
Conclusions:
- The RAPT tool effectively predicts post-acute care needs for spinal cancer surgery patients.
- Pre-operative prediction of non-home discharge can guide resource allocation and post-acute care planning.
- RAPT aids in optimizing care for spinal oncology patients.
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