Can the Blaylock Risk Assessment Screening Score (BRASS) predict length of hospital stay and need for comprehensive discharge planning for patients following hip and knee replacement surgery? Predicting arthroplasty planning and stay using the BRASS

• Published in: Canadian Journal of Surgery 2014-12, Vol.57 (6), p.391-397
• Main Authors: Cunic, Danny, MD, MSc, PhD, Lacombe, Shawn, BPHE, MSc, Mohajer, Kiarash, BSc, Grant, Heather, MSc, Wood, Gavin, MBChB
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - statistics & numerical data; Arthroplasty, Replacement, Knee - statistics & numerical data; Discharge; Evaluation; Female; Health risk assessment; Health Status Indicators; Hospitals; Humans; Joint surgery; Length of Stay - statistics & numerical data; Male; Middle Aged; Osteoarthritis - surgery; Patient Discharge - statistics & numerical data; Patients; Risk Assessment; Sensitivity and Specificity; Studies; Surgery
• ISSN: 0008-428X; 1488-2310
• DOI: 10.1503/cjs.024113

Background Knee and hip arthroplasty constitutes a large percentage of hospital elective surgical procedures. The Blaylock Risk Assessment Screening Score (BRASS) was designed to identify patients in need of discharge planning. The purpose of this study was to evaluate whether the BRASS was associated with length of stay (LOS) in hospital following elective arthroplasty. Methods We retrospectively reviewed the charts of individuals undergoing primary elective arthroplasty for knee or hip osteoarthritis who had a documented BRASS score. Results In our study cohort of 241, both BRASS ( p < 0.001) and replacement type (hip v. knee; p = 0.048) were predictive of LOS. Higher BRASS was associated with older patients ( p < 0.001), higher American Society of Anesthesiologists score ( p < 0.001) and longer LOS ( p < 0.001). We found a specificity of 83% for a BRASS greater than 8 and a hospital stay longer than 5 days and a specificity of 92% for a BRASS greater than 10. Conclusion The BRASS represents a novel and significant predictor of LOS following elective arthroplasty. Patients with higher BRASS are more likely to stay in hospital 5 days or more and should receive pre-emptive social work consultations to facilitate timely discharge planning and hospital resources.