PMID- 36921234
OWN - NLM
STAT- MEDLINE
DCOM- 20230719
LR  - 20231011
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 93
IP  - 2
DP  - 2023 Aug 1
TI  - Development and External Validation of the Spinal Tumor Surgery Risk Index.
PG  - 462-472
LID - 10.1227/neu.0000000000002441 [doi]
AB  - BACKGROUND: Patients undergoing surgical procedures for spinal tumors are 
      vulnerable to major adverse events (AEs) and death in the postoperative period. 
      Shared decision making and preoperative optimization of outcomes require accurate 
      risk estimation. OBJECTIVE: To develop and validate a risk index to predict 
      short-term major AEs after spinal tumor surgery. METHODS: Prospectively collected 
      data from multiple medical centers affiliated with the American College of 
      Surgeons National Surgical Quality Improvement Program from 2006 to 2020 were 
      reviewed. Multiple logistic regression was used to assess sociodemographic, 
      tumor-related, and surgery-related factors in the derivation cohort. The spinal 
      tumor surgery risk index (STSRI) was built based on the resulting scores. The 
      STSRI was internally validated using a subgroup of patients from the American 
      College of Surgeons National Surgical Quality Improvement Program database and 
      externally validated using a cohort from a single tertiary center. RESULTS: In 
      total, 14 982 operations were reviewed and 4556 (16.5%) major AEs occurred within 
      30 days after surgery, including 209 (4.5%) deaths. 22 factors were independently 
      associated with major AEs or death and were included in the STSRI. Using the 
      internal and external validation cohorts, the STSRI produced an area under the 
      curve of 0.86 and 0.82, sensitivity of 80.1% and 79.7%, and specificity of 74.3% 
      and 73.7%, respectively. The STSRI, which is freely available, outperformed the 
      modified frailty indices, the American Society of Anesthesiologists 
      classification, and the American College of Surgeons risk calculator. CONCLUSION: 
      In patients undergoing surgery for spinal tumors, the STSRI showed the highest 
      predictive accuracy for major postoperative AEs and death compared with other 
      current risk predictors.
CI  - Copyright (c) Congress of Neurological Surgeons 2023. All rights reserved.
FAU - Alomari, Safwan
AU  - Alomari S
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
AD  - The HEPIUS Innovation Lab, Johns Hopkins Hospital, Baltimore, Maryland, USA.
FAU - Theodore, John
AU  - Theodore J
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
AD  - The HEPIUS Innovation Lab, Johns Hopkins Hospital, Baltimore, Maryland, USA.
FAU - Ahmed, A Karim
AU  - Ahmed AK
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
FAU - Azad, Tej D
AU  - Azad TD
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
FAU - Lubelski, Daniel
AU  - Lubelski D
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
AD  - The HEPIUS Innovation Lab, Johns Hopkins Hospital, Baltimore, Maryland, USA.
FAU - Sciubba, Daniel M
AU  - Sciubba DM
AD  - Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island 
      Jewish Medical Center and North Shore University Hospital, Northwell Health, 
      Manhasset, New York, USA.
FAU - Theodore, Nicholas
AU  - Theodore N
AUID- ORCID: 0000-0001-5355-2683
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore, Maryland, USA.
AD  - The HEPIUS Innovation Lab, Johns Hopkins Hospital, Baltimore, Maryland, USA.
LA  - eng
PT  - Journal Article
DEP - 20230315
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Humans
MH  - Neurosurgical Procedures/adverse effects
MH  - Postoperative Complications/epidemiology/surgery
MH  - Retrospective Studies
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - *Spinal Cord Neoplasms/surgery
MH  - *Spinal Neoplasms/surgery
MH  - Spine/surgery
EDAT- 2023/03/16 06:00
MHDA- 2023/07/19 06:42
CRDT- 2023/03/15 16:02
PHST- 2022/09/20 00:00 [received]
PHST- 2023/01/10 00:00 [accepted]
PHST- 2023/07/19 06:42 [medline]
PHST- 2023/03/16 06:00 [pubmed]
PHST- 2023/03/15 16:02 [entrez]
AID - 00006123-202308000-00025 [pii]
AID - 10.1227/neu.0000000000002441 [doi]
PST - ppublish
SO  - Neurosurgery. 2023 Aug 1;93(2):462-472. doi: 10.1227/neu.0000000000002441. Epub 
      2023 Mar 15.