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  • Surgery (Austin & Northern Health)
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    Accuracy of Preoperative Scoring Systems for the Prognostication and Treatment of Patients with Spinal Metastases.

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    Author
    Hibberd, CS; Quan, GMY
    Date
    2017
    Source Title
    International Scholarly Research Notices
    Publisher
    Hindawi Limited
    University of Melbourne Author/s
    Quan, Gerald; Hibberd, Catherine
    Affiliation
    Surgery (Austin & Northern Health)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Hibberd, C. S. & Quan, G. M. Y. (2017). Accuracy of Preoperative Scoring Systems for the Prognostication and Treatment of Patients with Spinal Metastases.. Int Sch Res Notices, 2017, pp.1320684-. https://doi.org/10.1155/2017/1320684.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255102
    DOI
    10.1155/2017/1320684
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574303
    Abstract
    BACKGROUND: In patients with spinal metastatic disease, survival prognosis is a key consideration in selection for surgery and determining the extent of treatment. Individual survival prediction however remains difficult. We sought to validate the prognostic accuracy of seven preoperative scoring systems. METHODS: 61 patients surgically treated for spinal metastases were retrospectively reviewed. Preoperative scores were calculated for Tokuhashi, Revised Tokuhashi, Bauer, Modified Bauer, Sioutos, Tomita, and van der Linden scoring systems. Prognostic value was determined by comparison of predicted and actual survival. RESULTS: The Revised Tokuhashi and Modified Bauer scoring systems had the best survival predictive accuracy. Rate of agreement for survival prognosis was the greatest for the Modified Bauer score. There was a significant difference in survival of the prognostic groups for all but the van der Linden score, being most significant for the Revised Tokuhashi, Bauer, Modified Bauer, and Tomita scoring systems (p ≤ 0.001). CONCLUSION: Overall, the scoring systems are accurate at differentiating patients into short-, intermediate-, and long-term survivors. More precise prediction of actual survival is limited and the decision for or against surgery should never be based on survival prognostication alone but should take into account symptoms such as neurological deficit or pain from pathological fracture and instability.

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