Journal of Neurosurgery Spine · IF 2.9 · August 12, 2026 · LoE III
The utility of the Risk Assessment and Prediction Tool in predicting discharge disposition, length of stay, and readmissions in patients undergoing transforaminal lumbar interbody fusion
Gabriel A. Gonzalez, Caden R. Moenning, Aaron Davidson, Michael Farias, Joseph E. Nassar, Nicolas L. Carayannopoulos, Zvipo Chisango, Candace Hurley, Andrew J. Chi, Christy C. Ciesla, Eren O. Kuris, Bryce A. Basques — Brown University
This retrospective cohort study of 116 patients undergoing open TLIF looked at whether the preoperative RAPT score (a tool originally designed for joint replacement) predicts discharge destination, length of stay, and 30-day readmission. Higher RAPT scores were associated with greater odds of home discharge (adjusted OR 2.17) and shorter length of stay (adjusted β −0.39 days), but RAPT was not associated with 30-day readmission, and its discrimination for facility discharge was only moderate (AUC 0.709).
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersSpine surgeons are increasingly asked to predict discharge needs preoperatively for bundled-payment and value-based care purposes, and this paper tests whether a tool borrowed from arthroplasty actually works for TLIF patients.
Conclusion strengthConfirms prior evidence
No concurrent comparison group, so no between-group effect can be judged against the MCID.
Presenting this at rounds? Start here
- ?If RAPT modestly predicts home discharge after TLIF but not readmission, how should surgeons weigh its score against other clinical judgment when counseling patients preoperatively?
- ?Given the wide, imprecise cutoffs found here (9.5 vs 8.5 vs 10.5), should institutions adopt RAPT for TLIF discharge planning now, or wait for validation in larger multicenter cohorts?