Are the Cumulated Ambulation Score and Risk Assessment and Prediction Tool useful for predicting discharge destination and length of stay following total knee arthroplasty?

Gkagkalis, Georgios; Pereira, L.C.; Fleury, Nicole; Lüthi, François; Lécureux, Estelle; Jolles, Brigitte M.

doi:10.23736/s1973-9087.19.05568-0

Cited by 10 publications

(9 citation statements)

References 31 publications

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“…The Cumulated Ambulation Score is already recognized as valid to use in several patient groups, including hip fracture, total knee replacement, acute abdominal surgery, and elderly with acute medical hospital admission. 2,10–14…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties of the Cumulated Ambulation Score French translation

et al. 2020

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Objective: To examine measurement properties (inter-rater reliability, agreement, validity, and responsiveness) of the Cumulated Ambulation Score French translation in patients with hip fracture. Design: Methodological study. Setting: A 20-bed orthopedic unit and 20-bed geriatric unit. Subjects: About 140 consecutive patients with a mean (SD) age of 83 (12) years. Interventions: The English version of the Cumulated Ambulation Score used to evaluate basic mobility was translated into French following international guidelines. Two raters independently assessed all patients on postoperative days one, two, three, and 30 after a hip fracture surgery. Relative and absolute inter-rater reliability and responsiveness (effect size for improvement from postoperative day two to 30) were evaluated. Convergent validity was analyzed by Spearman’s correlation coefficient comparing the Cumulated Ambulation Score with two other measures on postoperative day two and 30. Main measure: Cumulated Ambulation Score. Results: The weighted Kappa value ranged from 0.89 to 1.0. The standard error of measurement and the smallest real difference of the Cumulated Ambulation Score ranged, respectively, from 0.12 to 0.23 and from 0.32 to 0.6 points, while the effect size reached 1.03 (95% CI 0.87–1.26). There was a strong positive correlation comparing the Cumulated Ambulation Score with the French Tinetti Assessment Tool ( r ⩾ 0.83) and the French Mini Motor Test ( r ⩾ 0.79). Conclusions: Our findings indicate that the Cumulated Ambulation Score’s French version is a reliable and valid tool to assess patients’ basic mobility with hip fractures.

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Section: Introductionmentioning

confidence: 99%

Psychometric properties of the Cumulated Ambulation Score French translation

et al. 2020

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“… 2019 , Gkagkalis et al. 2019 , Ziemba-Davis et al. 2019 , Johnson et al.…”

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confidence: 99%

Influence of day of surgery and prediction of LOS > 2 days after fast-track hip and knee replacement

et al. 2020

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Background and purpose — Enhanced recovery programs have reduced length of stay (LOS) after hip and knee arthroplasty (THA/TKA). Although risk factors disposing to prolonged LOS are well documented, there is limited information on the role of weekday of surgery. This study analyzed the role of weekday of surgery and other potential risk factors for LOS > 2 days. Patients and methods — We included 10,576 unselected consecutive procedures between January 2016 and August 2017 within a multicenter fast-track THA/TKA collaboration with prospective collection of preoperative characteristics. We used multiple regression analysis of potential risk factors for LOS > 2 days followed by construction of a simple risk score from 0 to 15 points based on the calculated odds ratios. Results — Mean LOS was 1.9 (SD 1.8) days, with 80% of patients having surgery from Monday to Wednesday. Of these, 17% (95% CI 16–18) had a LOS > 2 days vs. 19% (CI 17–21) in those operated on Thursday and Friday. Patients were scheduled evenly throughout the week regardless of risk of LOS > 2 days and despite the fact that 38% (CI 35–40) of patients with ≥ 6 points (16% of the total population) had a LOS > 2 days compared with 14% (CI 13–14) in those with < 6 points. In these “high-risk” patients, the fraction with LOS > 2 days increased when having surgery on Thursdays or Fridays (43% CI 38–49) compared with Monday to Wednesday (37% CI 34–39). Interpretation — A detailed preoperative risk assessment may be helpful to plan the weekday of surgery in order to decrease LOS and weekend hospitalization.

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“…A number of tools have been produced that are specific to orthopaedic surgery; these include the Risk assessment and Prediction Tool (RAPT) (25) and the Baylock Risk Assessment Screening Score (BRASS) (26) -both determining discharge destination. The RAPT has shown mixed predictive capabilities for LOS in TKA amongst prospective studies (27,28) and there is a paucity of data for THA. Comparatively, BRASS was shown to predict LOS in TJA (29).…”

Section: Risk Assessment Toolsmentioning

confidence: 99%