A novel scoring system for assessing Chiari malformation type I treatment outcomes.

Leonardo Aliaga, Katherine E. Hekman, Reza Yassari, David Straus, Gaurav Luther, Judy Chen, Ajay Sampat, David Frim

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Outcome assessment for the management of Chiari malformation type 1 is difficult because of the lack of a reliable and specific surgical outcome assessment scale. Such a scale could reliably correlate postoperative outcomes with preoperative symptoms. We developed a novel scoring system and applied it retrospectively to 146 patients treated at our institution in order to create and verify a simple and quantifiable assessment of Chiari outcomes. The Chicago Chiari Outcome Scale (CCOS) uses 4 postoperative outcome categories (pain, nonpain symptoms, functionality, and complications) graded 1 to 4 for a total possible score of 16. As a comparison with current Chiari outcome methodology, each patient was also placed into a gestalt outcome group of "improved," "unchanged," or "worse" (I/U/W). Patients were stratified by CCOS scores and by I/U/W group. Stratifying patients by total CCOS scores showed that patients who achieved CCOS scores between 13 and 16 were predominantly in the I/U/W improved group (n = 101, 69%); scores between 9 and 12 were predominantly I/U/W unchanged (n = 39, 27%), and scores between 4 and 8 were I/U/W worse (n = 6, 4%). Symptom subscore results provided insight into the specifics of the overall outcome in addition to the more quantitative nature of the 16-point scale. We describe a CCOS that assigns higher scores to patients judged improved by gestalt I/U/W ratings and lower scores to those who were unchanged or worse while defining outcome in 4 specific subcategories. As such, this CCOS should allow for a more unified and quantifiable outcome assessment after Chiari surgery.

Original languageEnglish (US)
Pages (from-to)656-664; discussion 664-665
JournalNeurosurgery
Volume70
Issue number3
StatePublished - Mar 2012
Externally publishedYes

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Arnold-Chiari Malformation
Outcome Assessment (Health Care)
Pain

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Aliaga, L., Hekman, K. E., Yassari, R., Straus, D., Luther, G., Chen, J., ... Frim, D. (2012). A novel scoring system for assessing Chiari malformation type I treatment outcomes. Neurosurgery, 70(3), 656-664; discussion 664-665.

A novel scoring system for assessing Chiari malformation type I treatment outcomes. / Aliaga, Leonardo; Hekman, Katherine E.; Yassari, Reza; Straus, David; Luther, Gaurav; Chen, Judy; Sampat, Ajay; Frim, David.

In: Neurosurgery, Vol. 70, No. 3, 03.2012, p. 656-664; discussion 664-665.

Research output: Contribution to journalArticle

Aliaga, L, Hekman, KE, Yassari, R, Straus, D, Luther, G, Chen, J, Sampat, A & Frim, D 2012, 'A novel scoring system for assessing Chiari malformation type I treatment outcomes.', Neurosurgery, vol. 70, no. 3, pp. 656-664; discussion 664-665.
Aliaga L, Hekman KE, Yassari R, Straus D, Luther G, Chen J et al. A novel scoring system for assessing Chiari malformation type I treatment outcomes. Neurosurgery. 2012 Mar;70(3):656-664; discussion 664-665.
Aliaga, Leonardo ; Hekman, Katherine E. ; Yassari, Reza ; Straus, David ; Luther, Gaurav ; Chen, Judy ; Sampat, Ajay ; Frim, David. / A novel scoring system for assessing Chiari malformation type I treatment outcomes. In: Neurosurgery. 2012 ; Vol. 70, No. 3. pp. 656-664; discussion 664-665.
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