What is the clinical evidence from this study?

Study design: Cohort. Population: Osteoporotic vertebral compression fractures (n=184). Intervention: ASA Physical Status Score and Charlson Comorbidity Index. Primary outcome: Death by the close of the study period (p=0.0150).

January 1, 2015The International Journal of Spine SurgeryOpen Access

Mortality Prediction in a Vertebral Compression Fracture Population: the ASA Physical Status Score versus the Charlson Comorbidity Index

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Key result

The ASA score was significantly predictive of mortality in the surgical population (p=0.0150), while the Charlson Comorbidity Index was highly predictive of mortality in the non-surgical population (p=0.0161).

Why the study?

Does the ASA score or Charlson Comorbidity Index better predict mortality in patients with osteoporotic vertebral compression fractures undergoing surgical versus conservative treatment?

Population

184 patients with osteoporotic vertebral compression fractures treated by the same orthopedic surgeon…

Design

Cohort, A board certified Anesthesiologist blindly assigned all of the ASA…

Follow-up

Up to 6 years (June 2000 to September 2006)

Authors

ELElizabeth A. Demers LavelleSUNY Upstate Medical University RCRobert Cheney WLWilliam F. LavelleSyracuse University

Discussion

Member takes

Implication

Supports treatment-specific risk stratification with ASA or CCI in vertebral compression fractures; leaves open prospective validation before guiding decisions.

Study Design

Type

Cohort (n=184)

Blinding

Single-blind (outcome assessor)

Multicenter

Structured PICO

Does the ASA score or Charlson Comorbidity Index better predict mortality in patients with osteoporotic vertebral compression fractures undergoing surgical versus conservative treatment?

Population

184 patients with osteoporotic vertebral compression fractures treated either conservatively or surgically, followed for up to 6 years to evaluate mortality predictors.

Exposure

American Society of Anesthesiologists Physical Status (ASA) score and Charlson Comorbidity Index (CCI) assessment

Outcome

Death by the close of the study period (September 2006)hard clinical

Main Result

p-value: p=0.0150

The ASA score is a better predictor of mortality in surgical patients with vertebral compression fractures, whereas the Charlson Comorbidity Index is better for non-surgical patients.

Limitations

A single physician assigned the ASA and Charlson scores in a retrospective manner.
The ASA score has known low inter-observer reliability.
Potential selection bias, as the surgeon may have selected healthier patients for surgery.
Single physician assigned scores retrospectively
Surgeon may have selected healthier patients for surgery (selection bias)

Cite This Study

Lavelle et al. (2015) conducted a cohort in Osteoporotic vertebral compression fractures (n=184). ASA Physical Status Score and Charlson Comorbidity Index was evaluated on Death by the close of the study period (p=0.0150). The ASA score was significantly predictive of mortality in the surgical population (p=0.0150), while the Charlson Comorbidity Index was highly predictive of mortality in the non-surgical population (p=0.0161).

synapsesocial.com/papers/6a959fea6f6cd511eea6a26c https://doi.org/10.14444/2063

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Implication

Supports treatment-specific risk stratification with ASA or CCI in vertebral compression fractures; leaves open prospective validation before guiding decisions.

Mortality Prediction in a Vertebral Compression Fracture Population: the ASA Physical Status Score versus the Charlson Comorbidity Index

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Mortality Prediction in a Vertebral Compression Fracture Population: the ASA Physical Status Score versus the Charlson Comorbidity Index

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider