Initial Assessment of the Risk Assessment and Prediction Tool in a Heterogeneous Neurosurgical Patient Population
| Autor: | Matthew Piazza, Diana Gardiner, Nikhil Sharma, Scott D. McClintock, Neil R. Malhotra, J Lachlan Smith, Danielle Callahan, M. Sean Grady, Emily Missimer, Benjamin Osiemo, William C. Welch, Eileen Maloney, James M. Schuster |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Population Neurosurgery Logistic regression Risk Assessment Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Risk Factors Humans Medicine Grading (education) education Aged Skilled Nursing Facilities education.field_of_study business.industry Middle Aged Patient Discharge Logistic Models Elective Surgical Procedures 030220 oncology & carcinogenesis Multivariate Analysis Emergency medicine Cohort Female Surgery Observational study Neurology (clinical) business Risk assessment 030217 neurology & neurosurgery |
| Zdroj: | Neurosurgery. 85:50-57 |
| ISSN: | 1524-4040 0148-396X |
| Popis: | BACKGROUND Bundled care payments are increasingly being explored for neurosurgical interventions. In this setting, skilled nursing facility (SNF) is less desirable from a cost perspective than discharge to home, underscoring the need for better preoperative prediction of postoperative disposition. OBJECTIVE To assess the capability of the Risk Assessment and Prediction Tool (RAPT) and other preoperative variables to determine expected disposition prior to surgery in a heterogeneous neurosurgical cohort, through observational study. METHODS Patients aged 50 yr or more undergoing elective neurosurgery were enrolled from June 2016 to February 2017 (n = 623). Logistic regression was used to identify preoperative characteristics predictive of discharge disposition. Results from multivariate analysis were used to create novel grading scales for the prediction of discharge disposition that were subsequently compared to the RAPT Score using Receiver Operating Characteristic analysis. RESULTS Higher RAPT Score significantly predicted home disposition (P |
| Databáze: | OpenAIRE |
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