Mrs Alicia Cerra1, Mr Asher Kirk1,2, Dr Angela Burge1,2, Dr Lara Kimmel1,2
1Alfred Health, Melbourne, Australia, 2Monash University, Melbourne, Australia
Biography:
Alicia Cerra is a physiotherapist at Alfred Health in Melbourne. She graduated with a Masters of Physiotherapy from Latrobe University in 2019. She works in acute musculoskeletal areas including trauma, orthopaedics and burns. She has participated in multiple quality and research projects throughout her career.
Abstract:
Background:
The Risk Assessment and Prediction tool (RAPT) is validated to predict the need for inpatient rehabilitation following total joint arthroplasty (TJA). With current practice and shorter hospital length of stay (LOS), a revised tool was created to improve the accuracy of predicting discharge within 3 days of surgery.
Methods:
All total knee (TKA) and hip (THA) arthroplasty patients within Alfred Health between November 2022 and March 2024 were included. Data was collected to score the original RAPT, as well as the American Society of Anaesthesiologist (ASA) score. An algorithm based on surgery type, age, joint, RAPT and ASA score was applied to predict LOS (revised RAPT; reRAPT). Demographic and clinical data including actual acute LOS (classified as ≤3 days, 4-6 days or ≥7 days) and discharge destination, were analysed to determine the sensitivity and specificity of the reRAPT.
Results:
Of 394 patients (age mean 69 [SD 10] years, 228 [58%] female), 162 (41%) had an ASA score ≥3 and 205 (52%) underwent TKR. 176 (45%) patients stayed ≤3 days and 350 (89%) were discharged home. The original RAPT tool demonstrated a sensitivity of 58% (102/176) and specificity of 71% (154/218) to predict ≤3 days LOS. Sensitivity was improved using the reRAPT (73%, 129/176). Specificity did not improve using the revised tool (58%, 126/218).
Discussion/Conclusion:
Aligned with clinical practice aiming to reduce LOS, the reRAPT improved sensitivity to predict LOS ≤3 days post TJA compared to the original RAPT. This can help clinicians allocate resources and facilitate discharge planning.