Abstract

BACKGROUND CONTEXT:Metastatic spinal cord compression (MSCC) presents complex treatment dilemmas where predicting survival is crucial for clinical decision-making PURPOSE:The New England Spinal Metastasis Score (NESMS) has shown promise,but external validation is needed to confirm its broader  applicability. STUDYDESIGN:Patients were assigned NESMS retrospectively based on ambulatory status,serum albumin level,and modified Bauerscore. PATIENTSAMPLE:This retrospective multicentre study included 322 adult patients with radiologically confirmed MSCC who presented for initial treatment over a3-year period at 2 partner institutions. OUTCOME MEASURES:The primary outcome was mortality at 12 months, with secondary out-comes of mortality at 3 and 6 months. METHODS: Kaplan-Meier survival analysis and multivariate logistic regression were used to evaluate NESMS  performance in predicting mortality and its discriminative capacity, while adjusting for potential confounders. RESULTS:The cohort had a median age of 70years, with 65% malepatients.Overall 12 month mortality was 5%. NESMS demonstrated excellent discriminative capacity for predicting 12-month mortality

CONCLUSIONS:This study externally validates the usefulness of the NESMS inpredicting survival for both operative and nonoperative patients with MSCC. Further,we observed clear stepwise increases in mortality with worsening NESMS.  To view the full paper click here.