OP0088-HPR Prediction of Inpatient Functional Recovery for Patients after Total Hip Arthroplasty: the Added Value of Performance-Based Test to Self-Reported Information: A Prospective Cohort Study

Abstract

Introduction: Current pathways for total hip arthroplasty (THA) aim to minimize length of stay. Optimization of preoperative risk screening could contribute to postoperative recovery and discharge planning. The Risk Assessment and Predictor Tool (RAPT) is an existing model for predicting recovery for patients after THA, containing self-reported information. The aim of this study is to evaluate the RAPT as a prediction tool for delayed inpatient functional recovery and to study the predictive value after adding performance-based functional data. Methods: We used a prospective cohort study design. Preoperative screening of patients attending for THA (2012) entailed six independent factors (Table 1). The dependent outcome parameter was delayed inpatient functional recovery (needing more than 3 days after surgery to reach independence in walking). Predictive value was tested using logistic regression and the Area under the curve (AUC). Results: 315 patients were included. Mean age was 69 years (SD 11) and length of stay was 4.1 days (SD 1.6). Delayed functional recovery was apparent in 47 people (15%). All functional tests were related to functional recovery (Table 1). Walking speed and the Timed up and go test increased the accuracy of RAPT significantly (Figure 1). (Figure Presented) Conclusions: Adding performance-based tests to the RAPT score resulted in more accurate predictions regarding the inpatient functional recovery of patients after THA. Prediction models should be optimized to detect low and high risk patients in order to establish (cost)effective and efficient rehabilitation in clinical pathways for THA.