64. A novel scoring system incorporating sarcopaenia to predict postoperative survival in spinal metastasis

Abstract

<h3>BACKGROUND CONTEXT</h3> As the prevalence of spinal metastasis rises, methods to predict survival will become increasingly important for clinical decision-making. Sarcopaenia may be used to predict survival in these patients. <h3>PURPOSE</h3> Our aim was to develop a prediction model for postoperative survival in patients with spinal metastasis. <h3>STUDY DESIGN/SETTING</h3> This was a retrospective cohort study. <h3>PATIENT SAMPLE</h3> Two hundred patients undergoing operative intervention for spinal metastasis were included. <h3>OUTCOME MEASURES</h3> The primary outcome measure was one-year postoperative survival. The secondary outcome measures were 3-month and 6-month postoperative survival. <h3>METHODS</h3> Clinicopathological and survivorship data were collated. Sarcopenia was defined using the L3 Psoas/Vertebral Body Ratio on cross-sectional CT. Independent predictors of survival were assessed by multiple logistic regression. Statistical analysis was conducted using GraphPad Prism statistical software. <h3>RESULTS</h3> Overall 1-year postoperative survival was 50%. L3/Psoas ratio 1.5 (OR 6.2), albumin35g/l (OR 3.0) and primary type were found to be independent predictors of 3-month, 6-month and 1-year postoperative survival on multivariable analysis. Age at surgery, ambulatory status and mode of presentation were not independent predictors of survival. Variables were used to generate a new scoring system to predict postoperative survival. This had greater correlation with postoperative survival than previous scoring systems. <h3>CONCLUSIONS</h3> This is the first model to incorporate sarcopaenia to predict survival in spinal metastasis patients and is more predictive than previous models in this cohort. This tool may be increasingly useful for informed decision-making for patients and surgeons. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.