Scholarlink

Purpose <p>To (1) quantify the national incidence and timing of in-hospital mortality after cervical fusion, (2) identify independent patient and hospital-level predictors, and (3) provide foundational data to inform cervical fusion-specific mortality risk tools.</p> Methods <p>We analyzed the National Inpatient Sample (NIS) from 2016 to 2022 for adult cervical fusion admissions. Baseline characteristics were compared with chi-square tests. A survey-weighted logistic regression modeled in-hospital death as the primary outcome, adjusting for demographics, payer, hospital region/size/teaching status, single versus multilevel fusion, surgical approach, Elixhauser comorbidities, and comorbidity count. Significance was set at the <i>P</i> &lt; 0.05 level.</p> Results <p>In-hospital deaths clustered early during the index admission, with most occurring within two weeks and the vast majority by one month. Older age increased mortality (65–74 years OR 3.69, <i>P</i> = 0.017; ≥75 years OR 8.27, <i>P</i> &lt; 0.001). Female sex was protective (OR 0.50, <i>P</i> &lt; 0.001). Combined anterior/posterior approaches were independently associated with higher mortality compared with posterior procedures (OR 2.56, <i>P</i> &lt; 0.001), whereas no difference was observed between anterior and posterior approaches (<i>P</i> = 0.881). Greater comorbidity burden raised risk (OR 1.26, <i>P</i> &lt; 0.001). Congestive heart failure (OR 2.61, <i>P</i> &lt; 0.001), coagulopathy (OR 2.90, <i>P</i> &lt; 0.001), and neurologic disorders (OR 9.79, <i>P</i> &lt; 0.001) were associated with higher mortality. Large hospitals had higher mortality relative to small hospitals (OR 1.99, <i>P</i> = 0.006).</p> Conclusions <p>In-hospital mortality after cervical fusion concentrates in the early postoperative period and is driven by advanced age, comorbidity burden, surgical approach, and select medical conditions. These findings highlight a narrow window for prevention/rescue and support development of cervical fusion-specific mortality prediction tools that integrate frailty/comorbidity and hospital factors.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Timing and predictors of in-hospital mortality after cervical fusion: A National Inpatient Sample study from 2016 to 2022

  • 期刊论文

  • 发表日期：

    2026年2月3日

查看全文
  • Mitchell K. Ng,
  • Leonidas E. Mastrokostas,
  • Paul G. Mastrokostas,
  • Matthew W. Xie,
  • Anton J. Cristofoli,
  • Sean Inzerillo,
  • Gregorio Baek,
  • Abigail Razi,
  • Afshin E. Razi,
  • Daniel R. Fassett,
  • Andrew P. Alvarez,
  • Ian David Kaye,
  • Mark F. Kurd,
  • Thomas D. Cha,
  • Jose A. Canseco,
  • Alan S. Hilibrand,
  • Alexander R. Vaccaro,
  • Gregory D. Schroeder,
  • Christopher K. Kepler

摘要

Purpose

To (1) quantify the national incidence and timing of in-hospital mortality after cervical fusion, (2) identify independent patient and hospital-level predictors, and (3) provide foundational data to inform cervical fusion-specific mortality risk tools.

Methods

We analyzed the National Inpatient Sample (NIS) from 2016 to 2022 for adult cervical fusion admissions. Baseline characteristics were compared with chi-square tests. A survey-weighted logistic regression modeled in-hospital death as the primary outcome, adjusting for demographics, payer, hospital region/size/teaching status, single versus multilevel fusion, surgical approach, Elixhauser comorbidities, and comorbidity count. Significance was set at the P < 0.05 level.

Results

In-hospital deaths clustered early during the index admission, with most occurring within two weeks and the vast majority by one month. Older age increased mortality (65–74 years OR 3.69, P = 0.017; ≥75 years OR 8.27, P < 0.001). Female sex was protective (OR 0.50, P < 0.001). Combined anterior/posterior approaches were independently associated with higher mortality compared with posterior procedures (OR 2.56, P < 0.001), whereas no difference was observed between anterior and posterior approaches (P = 0.881). Greater comorbidity burden raised risk (OR 1.26, P < 0.001). Congestive heart failure (OR 2.61, P < 0.001), coagulopathy (OR 2.90, P < 0.001), and neurologic disorders (OR 9.79, P < 0.001) were associated with higher mortality. Large hospitals had higher mortality relative to small hospitals (OR 1.99, P = 0.006).

Conclusions

In-hospital mortality after cervical fusion concentrates in the early postoperative period and is driven by advanced age, comorbidity burden, surgical approach, and select medical conditions. These findings highlight a narrow window for prevention/rescue and support development of cervical fusion-specific mortality prediction tools that integrate frailty/comorbidity and hospital factors.