The study authors gathered data on 22,006 spinal fusion cases, 4,759 of which were outpatient, from the National Surgical Quality Improvement database. The one- and two-level procedures were performed from 2011 to 2014. The researchers found:
1. There were 6,890 two-level cases all together and 20.7 percent were performed in the outpatient setting.
2. The complication rate for outpatient two-level spinal fusions was 1.47 percent, compared to 3.94 percent for inpatients.
3. There was a lower rate of postoperative complications among outpatient procedures, according to a propensity-adjusted multivariate regression model.
4. The independent risk factors for post discharge complications among the spinal fusion patients were:
• Greater comorbidity burden
• Higher ASA class
• Chronic steroid use
• Hypertension
• Male sex
5. Study authors concluded, “After adjusting for selection bias and patient risk factors, outpatient two-level ACDF was not associated with increased postoperative morbidity relative to inpatients, and may be considered in appropriately indicated patients.”
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