Validation of the Calgary Spine Severity Score
Godefroy Hardy St-Pierre1, Andrew Jack1, Ken Thomas2
1Division of Neurosurgery, University of Alberta, Univ 2D1 02 WMC, 8440 112 St N.W., Edmonton, Alberta, Canada T6G 2B7.
Summary
The Calgary Spine Severity Score (CSSS) was validated in an unselected patient sample. A modified CSSS significantly improved accuracy in predicting surgical wait times, requiring further external validation.
Area of Science:
- Spine surgery
- Clinical outcomes
- Triage scores
Background:
- The Calgary Spine Severity Score (CSSS) stratifies spine referrals by urgency.
- External validation in unselected patients is needed.
Purpose of the Study:
- To validate the Calgary Spine Severity Score (CSSS).
Main Methods:
- Validation study of 316 consecutive spinal surgery patients.
- Compared CSSS-predicted time to operating room (OR) with actual time.
- Used Kaplan-Meier survival analysis and Cox proportional hazard models.
Main Results:
- Original CSSS accuracy was 63%, with significant over/underestimation.
- Seven cauda equina syndrome cases were misclassified.
- Modified CSSS achieved 96% accuracy, with improved concordance and R-square.
Conclusions:
- A modified CSSS offers substantial improvement over the original.
- The modified score is easy to use and requires further external validation.
Keywords:
Calgary Spine Severity ScoreMedical decision processMethodologyTime to ORTriage scoreValidation
