• Maximilian F Kasparek, Friedrich Boettner, Anna Rienmueller, Michael Weber, Philipp T Funovics, Petra Krepler, Reinhard Windhager, and Josef Grohs.
• Department of Orthopaedics and Trauma Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
• Eur Spine J. 2018 Oct 1; 27 (10): 2449-2456.

PurposeThe preoperative prediction of medical complications is essential to optimize perioperative management. SpineSage™ is a free of charge online calculator to predict medical complications in spine surgery. The current study utilizes it in patients undergoing spine surgery to assess whether the predicted risks would correlate with the actual complication rate in clinical practice.MethodsA total of 273 consecutive patients who underwent spinal surgery were assessed. The risk of medical complications was predicted for each patient, and all medical complications were recorded within 30 days of surgery. Based on their predicted risk of complication, patients were divided into three risk groups (< 15, 15-30, > 30%).ResultsThe predicted overall risk of medical complications was 14.7% and was comparable to the observed complication rate of 16.1%. The predicted risk for major medical complications (3.8%) was also similar to the observed complication rate (3.3%). Detailed analysis of the segmented risk groups suggests a close correlation between predicted and actual complication rates. Receiver operating characteristic analysis revealed an area under the curve of 0.71 (p < 0.001) for the prediction of overall medical complications and 0.85 (p < 0.001) for major complications.ConclusionsThe online risk calculator predicted both overall and major medical complications. The tool can assist in preoperative planning and counseling of patients. These slides can be retrieved under Electronic Supplementary Material.

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