• Nikita Lakomkin, Scott L Zuckerman, Blaine Stannard, Julio Montejo, Eric S Sussman, Justin Virojanapa, Gregory Kuzmik, Vadim Goz, Constantinos G Hadjipanayis, and Joseph S Cheng.
• Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY.
• Spine. 2019 Jul 1; 44 (13): E782-E787.

Study DesignA retrospective review of prospectively collected data.ObjectiveThe purpose of this study is to compare and validate several preoperative scores for predicting outcomes following spine tumor resection.Summary Of Background DataPreoperative risk assessment for patients undergoing spinal tumor resection remains challenging. At present, few risk assessment tools have been validated in this high-risk population.MethodsThe 2008 to 2014 National Surgical Quality Improvement database was used to identify all patients undergoing surgical resection of spinal tumors, stratified as extradural, intradural extramedullary, and intramedullary based on CPT codes. American Society of Anesthesiologists (ASA) score, modified Charlson Comorbidity Index (CCI), and modified Frailty Index (mFI) were computed. A binary logistic regression model was used to explore the relationship between these variables and postoperative outcomes, including mortality, major and minor adverse events, and hospital length of stay (LOS). Other significant variables such as demographics, operative time, and tumor location were controlled for in each model.ResultsTwo thousand one hundred seventy patients met the inclusion criteria. Higher CCI scores were independent predictors of mortality (OR = 1.24, 95% CI: 1.14-1.36, P < 0.001), major adverse events (OR = 1.07, 95% CI: 1.01-1.31, P = 0.018), minor adverse events (OR = 1.15, 95% CI: 1.10-1.20, P < 0.001), and prolonged LOS (OR = 1.14, 95% CI: 1.09-1.19, P < 0.001). Patients' mFI scores were significantly associated with mortality and LOS, but not major or minor adverse events. ASA scores were not associated with any outcome metric when controlling for other variables.ConclusionThe CCI demonstrated superior predictive capacity compared with mFI and ASA scores and may be valuable as a preoperative risk assessment tool for patients undergoing surgical resection of spinal tumors. The validation of assessment scores is important for preoperative risk stratification and improving outcomes in this high-risk group.Level Of Evidence3.

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