What is the clinical evidence from this study?

Study design: Cohort. Population: Lumbar fusion (n=1181465). Intervention: Risk factors (e.g., age ≥75 years, multilevel fusion, comorbidities) vs. Absence of risk factors. Primary outcome: in-hospital mortality.

What does this research mean for the field?

In-hospital mortality after lumbar fusion is 0.11%, occurring early, with age ≥75 years and multilevel fusion as strong independent predictors. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The aim is to analyze in-hospital mortality rates after lumbar fusion surgeries and identify risk factors for mortality.

February 6, 2026Global Spine Journal0 citationsOpen Access

In-Hospital Mortality After Lumbar Fusion is Rare But Occurs Early: A Nationwide Analysis of Risk Factors, 2016-2022

MNMitchell K. Ng LMLeonidas E. Mastrokostas PMPaul G. Mastrokostas

Key Result

In-hospital mortality after lumbar fusion was 0.11%, with independent predictors including age ≥75 years (OR 4.49), multilevel fusion (OR 2.09), and congestive heart failure (OR 4.46).

Key Points

The aim is to analyze in-hospital mortality rates after lumbar fusion surgeries and identify risk factors for mortality.
Analyzed adult lumbar fusion hospitalizations from the National Inpatient Sample (2016-2022)
Primary outcome was in-hospital mortality, secondary outcomes included timing of death and comorbidity comparisons
Used multivariable logistic regression to identify independent mortality predictors
In-hospital mortality was 0.11% (1290 deaths) with approximately 50% occurring within 7 days
Patients who died more often underwent multilevel fusions and were older (≥75 years)
Higher comorbidity burden was associated with increased mortality, including conditions like congestive heart failure and neurologic disorders

Study Design

Type

Cohort (n=1,181,465)

Multicenter

Yes

Structured PICO

Population

1,181,465 adult lumbar fusion hospitalizations from the National Inpatient Sample (2016-2022) analyzed for in-hospital mortality.

Exposure

Lumbar fusion

Outcome

In-hospital mortalityhard clinical

In-hospital mortality after lumbar fusion is rare (0.11%) but occurs early and is strongly predicted by older age, multilevel procedures, and medical complexity such as congestive heart failure.

Abstract

Study Design Retrospective cohort study. Objectives To update national estimates of in-hospital mortality after lumbar fusion, characterize when deaths occur during hospitalization, and identify independent predictors of mortality. Methods Adult (≥18 years) lumbar fusion hospitalizations in the National Inpatient Sample (NIS) from 2016 to 2022 were analyzed. The primary outcome was in-hospital mortality. Secondary outcomes included hospital-day timing of death and survivor–decedent comparisons of comorbidity and perioperative complication profiles. Multivariable logistic regression identified independent predictors ( P 90% by ∼ 30 days). Decedents more often underwent multilevel fusion (67.8% vs 38.8%, P < 0.001), were aged ≥75 years (41.5% vs 16.5%, P < 0.001), and had higher comorbidity burden (mean Elixhauser count 3.92 vs 2.15, P < 0.001). Independent predictors included age ≥75 years (OR 4.49, P = 0.003), multilevel fusion (OR 2.09, P < 0.001), congestive heart failure (OR 4.46, P < 0.001), coagulopathy (OR 3.44, P < 0.001), neurologic disorders (OR 9.27, P < 0.001), peripheral vascular disease (OR 1.61, P = 0.031), and higher comorbidity count (per-point OR 1.16, P = 0.010). Female sex (OR 0.72, P = 0.022) and highest income quartile (OR 0.58, P = 0.009) were protective. Conclusions In-hospital mortality after lumbar fusion is uncommon but concentrates early and disproportionately affects older, medically complex patients undergoing multilevel procedures, supporting preoperative counseling, front-loaded perioperative risk stratification, and heightened early postoperative vigilance.

AI से पूछें

Bookmark

View Full Paper