BACKGROUND: Predicting survival after surgery for patients with metastatic spine 
disease can be challenging, with multiple variables that can influence a 
patient's overall survival. Predictive models have been developed to assist 
clinicians in providing a prognosis for patients. Recently, Ghori et al. 
reported a composite model taking into account a modified Bauer score, 
preoperative albumin, and ambulatory status of patients with spinal metastasis. 
Using an independent cohort, we sought to assess the reliability and validity of 
this composite model to predict 1-year survival in patients diagnosed with 
metastatic cancer to the spine.
PURPOSE: This study aimed to assess the reliability and validity of the Ghori 
et al. composite model to predict 1-year survival in patients diagnosed with 
metastatic cancer to the spine, using an independent cohort.
STUDY DESIGN/SETTING: A retrospective study was carried out.
PATIENT SAMPLE: The sample comprised 161 patients with spinal metastasis 
undergoing surgery.
OUTCOME MEASURES: Patients' modified Bauer score, preoperative albumin, and 
ambulatory status were assessed.
METHODS: This study used a retrospective analysis of 161 patients with spinal 
metastasis who underwent surgical management from 2007 to 2013. The ability of 
this composite model to predict 1-year survival was compared with actual patient 
survival using multivariable logistic regression to control for confounders, as 
well as post-regression diagnostics.
RESULTS: Our analysis revealed significantly lower 1-year mortality among 
patients with higher composite scores as compared with those with lower scores. 
Strong associations between scores and survival were appreciated in unadjusted 
analysis. The final model was able to account for 80% of the variation in the 
1-year survival, and there was no evidence of lack of fit.
CONCLUSION: This study demonstrates, in an independent cohort of spinal 
metastases patients, that a composite model taking into account the ambulatory 
status, serum albumin, and modified Bauer score is able to better predict 
postoperative survival. These data serve to validate the use of this predictive 
model in determining the prognosis of patients with spinal metastasis.