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5-fold higher ( .01) in patients with ASD-CS of 4 through 6; and 7.5-fold higher ( .01) in patients with ASD-CS of 7 or 8. Patients with ASD-CS of 7 or 8 had the longest mean LOS (10.7 days) and worst mean Scoliosis Research Society-22r total score at baseline; however, they experienced the greatest mean improvement (0.98 points) over 2 years. The ASD-CS is significantly associated with major complications, LOS, and patient-reported outcomes in operatively treated ASD patients. The ASD-CS is significantly associated with major c