title: 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.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Division of Orthopedic Surgery, Queens University, Kingston, Ont.
authors.forename: Danny
authors.initials: D
authors.lastname: Cunic
authors.affiliation: The School of Medicine, Queens University, Kingston, Ont.
authors.forename: Shawn
authors.initials: S
authors.lastname: Lacombe
authors.affiliation: The School of Medicine, Queens University, Kingston, Ont.
authors.forename: Kiarash
authors.initials: K
authors.lastname: Mohajer
authors.affiliation: The Human Mobility Research Centre, Kingston, Ont.
authors.forename: Heather
authors.initials: H
authors.lastname: Grant
authors.affiliation: The Division of Orthopedic Surgery, Queens University and the Human Mobility Research Centre, Kingston, Ont.
authors.forename: Gavin
authors.initials: G
authors.lastname: Wood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010351:Patient Discharge / Q000706:statistics & numerical data; D018570:Risk Assessment; D012680:Sensitivity and Specificity