Reliability and consistency analysis of the Spanish version of the blaylock risk assessment screening score for discharge planning in hospitalised adults

OBJECTIVE: To assess the predictive validity and reliability of the Spanish version of the Blaylock Risk Assessment Screening Score (BRASS-Sp) in relation to continuity of care variables and clinical safety outcomes in hospitalised patients. METHODS: A retrospective observational analytical study was conducted in a sample of 3566 inpatients from a university hospital. Sociodemographic, clinical, and adverse event data were extracted from electronic health records. Multivariable regression models, ROC curve analyses, and exploratory and confirmatory factor analyses were performed. Internal consistency was assessed using McDonald's ω. The study followed the Guidelines for Reporting Reliability and Agreement Studies (GRRAS). RESULTS: The BRASS-Sp index showed acceptable internal consistency (ω = 0.79), but limited predictive validity for key outcomes, including readmissions, emergency department visits, and prolonged length of stay (AUC range: 0.51-0.55). Predictive performance was acceptable only for in-hospital mortality (AUC = 0.75). Factor analysis identified a three-factor structure with moderate inter-factor correlations. No significant associations were found between BRASS-Sp scores and most adverse events. CONCLUSIONS: The BRASS-Sp index demonstrates limited clinical utility as a screening tool for discharge planning and continuity of care in this setting. Despite acceptable reliability, its low predictive capacity raises concerns regarding its effectiveness in routine clinical practice. Further research is needed to develop and validate more robust risk assessment tools adapted to the Spanish healthcare context.