Open AccessUtility of Surgical Risk Calculators in Spine Surgery in Patients Aged Over 80 Years: Analysis of SpineSage and ACS NSQIP
Author(s) -
James E. Willoughby,
Joseph F. Baker
Publication year - 2022
Publication title -
global spine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.398
H-Index - 26
eISSN - 2192-5690
pISSN - 2192-5682
DOI - 10.1177/21925682221074659
Subject(s) - medicine , receiver operating characteristic , cohort , retrospective cohort study , surgery , framingham risk score , risk assessment , cohort study , disease , computer security , computer science
Study Design Retrospective cohort study.Objective To validate the predictive accuracy of both the SpineSage and ACS-NSQIP surgical risk calculators in patients over the age of 80 years, undergoing spine surgery for any reason.Methods We included 210 consecutive patients treated with single-stage spine surgery at our institution between 2009 and 2019. The demographic details and preoperative characteristics of each patient were collected and reviewed for entry into both the SpineSage and ACS risk calculators. The estimated risk supplied by these calculators was compared to the observed rate of complications post-surgery. The main method of comparison was using receiver operating characteristic (ROC) curve analysis.Results Complications were identified in 51 patients (24%). Most patients underwent surgery for a degenerative cause (71%), with the majority of procedures performed on the lumbosacral spine (66%). Receiver operating characteristic (ROC) curves were calculated to compare the outcomes of each tool. Area under the curve (AUC) analysis showed similar predictive accuracy between SpineSage and ACS when predicting overall complications (0.688; P 80 years, SpineSage appears to be preferable to the ACS-NSQIP surgical risk calculator in this single centre cohort, SpineSage was more accurate in predicting the risk of serious medical complications. The accuracy of both of these tools could still be improved upon.