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Researchers develop index to better predict metastatic spine disease survival
The new score is internally validated and outperforms the Tokuhashi, Tomita and modified Bauer scores, researchers said.
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BIRMINGHAM, England — A simple new score researchers developed from existing scores may be a good tool to predict survival in patients with metastatic spine disease, according to a presenter.
“Although our score is devised from these previous three scores, it outperforms them in its predictive value,” Specialty Trainee Anuj Jaiswal, MS, MRCS, at Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, in Oswestry, United Kingdom, said at the British Orthopaedic Association Congress, here.
The new score that Jaiswal and colleagues developed is the Oswestry Spinal Risk Index (OSRI).
Prospective study
At the meeting, Jaiswal presented results of the prospective study that he and his colleagues conducted and recently had published in the Bone and Joint Journal. The study included 199 consecutive patients with spinal metastases – mostly men – with a mean age of 62 years (range 23 to 86 years).
Jaiswal and colleagues did a side-by-side comparison of the Tokuhashi score, the Tomita score and the modified Bauer score, all of which are used in the management of patients who present with spinal metastases.
“Unfortunately they are complex and can be unreliable,” Jaiswal said of the three scores that are now commonly used to predict metastatic spine disease outcomes.
Used best of all three scores
To create the new OSRI score, the researchers analyzed all items of the three previous scores, including primary tumor grade, which Jaiswal said is most relevant to survival. Then they systematically combined similar items from the other scores that were redundant and completely eliminated others to model the OSRI score, Jaiswal said.
He and his colleagues wrote in their study, “The OSRI is a simple summation of two elements: primary tumor pathology (PTP) and general condition (GC): OSRI=PTP+ (2 – GC).”
The researchers performed a Cox regression analysis to determine the ability of the OSRI to accurately predict survival in all the patients compared to the available scoring systems.
“We identified a problem that other scores can be unreliable and complex, and developed a new score which is internally validated and outperforms the previous scores,” Jaiswal said. – by Susan M. Rapp
References:
Jaiswal A. The Oswestry Risk Index (OSRI) — An aid in the treatment of metastatic spine disease. Presented at: British Orthopaedic Association Congress. Oct.1-4, 2013. Birmingham, England.
For nmore information:
Disclosure: Jaiswal has no relevant financial disclosures.