Comparing the ESSG-ISSG calculator with other commonly used risk stratification tools.
| Predictive Tool | Factors Used to Predict Outcomes | Measured Outcome |
| ESSG-ISSG calculator | Twelve basic patient demographics: gender, age, height, weight, smoking history, prior spine surgery, heel walk, toe walk, leg weakness, ASA grade, NRS back pain, NRS leg pain Nine radiographic parameters: major curve location, Cobb angle, coronal balance, leg length discrepancy, L1-S1 angle, pelvic tilt, sacral slope, sagittal balance, global alignment 8 HRQL questions Nine surgical characteristics: number of stages, use of bone graft, use of antifibrinolytics, number of levels fused, upper instrumented vertebra, lower instrumented vertebra, implant density, posterior rod material, posterior rod diameter | Major complications, reinterventions, readmissions, and patient-reported outcomes including SRS-22, Oswestry Disability Index, SF36v2 |
| Charlson Comorbidity Index | Age, history of MI, CHF, PVD, DM, CKD, CVA/TIA, AIDS, liver disease, connective tissue disease, peptic ulcer disease, hemiplegia, solid tumor, leukemia, lymphoma | Estimated 10-y survival based on medical comorbidities |
| ACS-NSQIP Calculator | Age, BMI, functional status, ASA class History of HTN, DM, CHF, COPD, acute kidney injury, CKD requiring dialysis, smoking, ascites, sepsis, disseminated cancer | Postoperative risk of any complications, severe complications, cardiac complications, and death |
| SpineSageT | Age, BMI, gender, diagnosis Level (cervical, thoracic, lumbar), Approach (anterior, lateral, posterior) Previous spine surgery, revision surgery, previous cardiac complications History of CVA/TIA, COPD, asthma, HTN, rheumatoid arthritis, kidney disease, cancer, syncope/seizure, anemia, bleeding disorder, DM, CHF | Expected complication rates after various types of spine surgery |
| ASA | Patients clinically classified into 1 of the following categories based on multiple factors: I: normal healthy patient II: mild systemic disease III: severe systemic disease IV: severe systemic disease constant threat to life V: moribund patient not expected to survive without the operation | Preoperative risk of undergoing anesthesia |
| mFI-5 | CHF within 30 d of surgery Partially or totally dependent functional health status at time of surgery History of DM, COPD or pneumonia, HTN | Occurrence of adverse postoperative outcomes |
| mFI-11 | Functional status, history of HTN, DM, MI, PVD, CVD, cerebrovascular disease ± neurologic deficit, impaired sensorium, respiratory problems, other cardiac problems | Occurrence of adverse postoperative outcomes |
Abbreviations: ASA, American Society of Anesthesiology; BMI, body mass index; CHF, congestive heart failure; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; CVA, cerebrovascular accident; CVD, cardiovascular disease; DM, diabetes mellitus; ESSG, European Spine Study Group; HTN, hypertension; ISSG, International Spine Study Group; mFI, modified frailty index; MI, myocardial infarction; NRS, numeric rating scale; PVD, peripheral vascular disease; TIA, transient ischemic attack.