96. Assessing the predictive ability of metabolic syndrome-ATP III for survival and complications in patients with metastatic spinal cord compression

Abstract

BACKGROUND CONTEXT Metabolic syndrome (MetS) is a global epidemic disorder, especially in the Western capitalistic economic development model. PURPOSE To elucidate the predictive ability of the Adult Treatment Panel (ATP)-III for survival and complications in patients who underwent decompressive surgery (DS) for metastatic spinal cord compression (MSCC). STUDY DESIGN/SETTING Patients with MSCC presented at an academic tertiary care hospital from 2011 to 2018 were identified through retrospective chart review. PATIENT SAMPLE Statistical analysis included 119 patients (median age: 67 years; 63% males), with a median survival of 14 months (95%CI: 1-28.2 months, p=0.01). OUTCOME MEASURES Survival and complications following surgery for MSCC. METHODS Patients were categorized into MetS-ATP III (42.9%, n=51) if they met 3 or more of the following criterion: waist circumference (men >102 cm and women >88 cm), triglycerides (≥150 mg/dl), high density cholesterol (men RESULTS All-cause mortality and complications were 62.2% (n=74) and 22.7% (n=27) in our cohort respectively. Patients with MetS-ATP III had a 1.74-fold higher risk of mortality at last follow-up evaluation (HR: 1.74, 95%CI: 1.07-2.81, p=0.02), after adjusting for age, sex, tumor histology and spine instability neoplastic score (SINS). Overall complication rates were significantly higher among patients with MetS (HR: 4.06, 95% CI: 1.68-9.82, p=0.002). Furthermore, the patients with MetS had a higher probability of impaired wound healing (HR: 3.85, 95% CI: 1.57-9.40, p=0.003) and thrombotic disorders (HR: 5.56, 95%CI: 1.63-19.0, p=0.006), adjusted for age, sex, tumor histology and SINS. CONCLUSIONS MetS-ATP III analysis in patients with MSCC who underwent DS was effective in identifying patients at higher risk for shorter survival and more complications. However, further prospective studies are needed to validate our results. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.