Survival of patients undergoing surgery for metastatic spinal tumours and the impact of surgical site 2 infection

Article English OPEN
Atkinson, Ross A. ; Davies, Benjamin ; Jones, Anna ; Van Popta, Dmitri ; Ousey, Karen ; Stephenson, John (2016)

Summary\ud Background\ud Patients with metastatic spinal tumours have a limited prognosis. Surgical complications that may result in prolonged hospitalization or readmission are highly undesirable. Surgical site infection (SSI) is one such complication, which can, in extreme cases, lead to death.\ud \ud Aim\ud To assess the impact of SSI on patient survival after surgery for spinal metastases.\ud \ud Methods\ud Demographic, operative, and survival data were collected on 152 patients undergoing surgery for spinal metastasis at a large UK tertiary referral centre. American Society of Anesthesiologists (ASA) grade and the Revised Tokuhashi Score (RTS) were determined as measures of health status and prognosis, respectively, at baseline. A semi-parametric Cox proportional hazards survival analysis was used to assess the relationships between covariates and survival.\ud \ud Findings\ud Seventeen patients (11.2%) experienced SSI. Overall, median survival time from operation was 262 days (95% confidence interval: 190–334 days) and 12-month survival was 42.1%. RTS (hazard ratio: 0.82; 95% confidence interval: 0.76–0.89; P < 0.001) and ASA grade (1.37; 1.03–1.82; P = 0.028) were significantly associated with survival, with better survival found in patients with higher RTS and lower ASA scores. Infection status was of substantive importance, with better survival in those without SSI (P = 0.075).\ud \ud Conclusion\ud Twelve-month survival in patients undergoing surgery for spinal metastasis is ∼42%. RTS and ASA scores may be used as indicators of patient survival either in combination or individually. Whereas SSI has some negative impact on survival, a larger study sample would be needed to confirm whether this is statistically significant
  • References (26)
    26 references, page 1 of 3

    NICE, Metastatic spinal cord compression: diagnosis and management of patients at risk of or with metastatic spinal cord compression. 2008, National Collaborating Centre for Cancer: Cardiff.

    Klimo P, Jr. and Schmidt MH. Surgical management of spinal metastases. Oncologist, 2004.

    9(2): p. 188-96.

    Cancer Control, 2012. 19(2): p. 122-8.

    Urban JA. Cost analysis of surgical site infections. Surg Infect (Larchmt), 2006. 7 Suppl 1: p.


    Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE and Sexton DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol, 1999. 20(11): p. 725-30.

    Tokuhashi Y, Matsuzaki H, Oda H, Oshima M and Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976), 2005.

    30(19): p. 2186-91.

    Dripps RD, Lamont A and Eckenhoff JE. The role of anesthesia in surgical mortality. JAMA, 1961. 178: p. 261-6.

  • Metrics
    views in OpenAIRE
    views in local repository
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    University of Huddersfield Repository - IRUS-UK 0 52
Share - Bookmark