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8%) and disc degeneration (33.6%). Age, male gender, spinal parameters including PI, bone mineral density, back muscle strength, and gait ability differed significantly between the groups, whereas frailty and sarcopenia were not significantly different. Low PI, low lumbar lordosis, elder age, male gender, high BMI, and weak back muscle strength were significant risk factors for lumbar osteophyte formation and disc degeneration. CONCLUSIONS Low PI was identified as a risk factor for lumbar osteophyte formation and disc degeneration, both of which reduce physical QOL in middle-aged and elderly people. These slides can be retrieved under Electronic Supplementary Material.PURPOSE Clinical registries are used for quality management and clinical research. Due to the importance and implications of both aims, completeness and high quality of data are of paramount importance. However, this remains uncertain, as none of these registries have implemented independent monitoring. The aim of this study was to determine the accuracy and completeness of registry data o the example of the German Spine Society (DWG) registry. METHODS In a prospective study, audits by a board-certified neurosurgeon were conducted at certified spine centers with mandatory registry input, a setting comparable to most existing registries worldwide. A 2-week period was analyzed, and any discrepancy between patients' charts and the registry entry was evaluated. A median of 31 items per patient was evaluated including completeness and accuracy of data. RESULTS Out of 17 centers willing to participate, 4 were still lacking any data entries. Even in the remaining 13 centers eligible for audits, 28.50% (95%-CI = [22.46-34.55]) of entries were finalized only after the audits were announced. Only 82.55% (95%-CI = [79.12-85.98]) of surgeries were documented, and on average 14.95% (95%-CI = [10.93-19.00]) of entries were not accurate with a wide variation (range; 6.21-27.44%) between centers. Aspects for improvement of the situation were identified. CONCLUSION Due to the high inaccuracy, the high number of centers lacking mandatory entries at all and the number of false entries, these data alert us to advocate unannounced audits and further measures to improve the situation. Data should not be used for the time being, since wrong conclusion will be drawn. These slides can be retrieved under Electronic Supplementary Material.PURPOSE To investigate whether the rotation of preoperative-presumed lowest instrumented vertebra (LIV) is a risk factor for adding-on (AO) in adolescent idiopathic scoliosis (AIS) treated with selective posterior thoracic fusion (sPTF). METHODS A total of 196 AIS patients of Lenke type 1A or 2A with minimum 2-year follow-up after sPTF with all pedicle screw instrumentation were included. Radiographical parameters were measured as follows preoperative rotation angle of presumed LIV and LIV + 1, LIV + 1/LIV rotation difference, postoperative rotation angle of LIV and LIV derotation angle on CT scans. Patients were classified into AO group and non-AO group during the follow-up. The parameters were compared between the two groups to investigate risk factors for AO. RESULTS Among 196 patients, 40 (20.4%) patients developed with AO at the final follow-up. Compared with non-AO group, patients with AO had significantly larger preoperative rotation angle of presumed LIV (8.8° ± 3.4° vs. 3.4° ± 2.9°, P  less then  0.001) and LIV + 1 (5.9° ± 4.0° vs. 3.6° ± 2.9°, P = 0.004), LIV + 1/LIV rotation difference (- 2.6° ± 3.7° vs. 0.6° ± 3.2°, P  less then  0.001) and postoperative rotation angle of LIV (7.2° ± 4.3° vs. 3.0° ± 2.9°, P  less then  0.001). The last substantially touched vertebrae (LSTV) was selected as LIV in 148 patients, among which the above described parameters were found to be remarkably larger in AO group than non-AO group as well. Multivariate analysis presented Risser grade and preoperative rotation angle of presumed LIV as independent predictors of AO. CONCLUSION AIS patients with low Risser grade and large preoperative rotation angle of presumed LIV are more likely to develop with AO after sPTF. Moreover, for the patients with LSTV selected as LIV, preoperative rotation of presumed LIV might be still a risk factor associated with the occurrence of AO. LEVEL OF EVIDENCE III These slides can be retrieved under Electronic Supplementary Material.Since systolic pulmonary arterial pressure (SPAP) is an important diagnostic indicator for various cardiovascular diseases, it is of great significance to determine scientific SPAP reference value in clinical application. However, the SPAP reference values currently have not been applied under a unified standard, and its formulation does not consider the impacts from geographical environment which has proved to be closely associated with SPAP. This study aims to quantify the impacts of geographical factors on SPAP and formulate scientific SPAP reference values, thereby providing support for more accurate diagnosis. Measured SPAP values of 4550 healthy adults were collected from 88 cities across China, and 11 geographical factors were selected. Four geographical factors with significant impacts on SPAP were determined via correlation analysis, including two positive factors (altitude, soil organic matter) and two negative ones (longitude, annual average temperature). Then partial least-squares regression analysis (PLSR) and trend surface analysis were applied to establish predictive models. Through model test using both collected and simulated SPAP data of control points, the PLSR model was determined to have better prediction accuracy and was selected as optimal model to calculate the SPAP reference values of 2322 cities in China. The predictive results ranged from 22.09 to 31.77 mmHg. Finally, hotspot analysis and kriging interpolation method were applied to explore the spatial distribution of SPAP reference values. The result of spatial analysis shows that SPAP reference values of Chinese adults decreased gradually from the West to East in China. CCI-779 This study indicated the significant impacts of geographical environment on SPAP and established predictive model for determining SPAP reference values, which is expected to help enhance clinical diagnostic accuracy.
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