ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Dialysis status and its association with complications, discharge outcomes, and costs after multilevel lumbar fusion: a national analysis.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe purpose of this study was to compare perioperative outcomes between dialysis-dependent and non-dialysis patients undergoing multilevel lumbar fusion.
methodsThe National Inpatient Sample (2016–2022) was queried for adults undergoing elective multilevel lumbar fusion. Dialysis dependence was identified using ICD-10-CM codes. Demographic, clinical, and hospital characteristics were compared between groups using survey-weighted analyses. Multivariable logistic regression examined the independent association between dialysis status and complications, non-routine discharge, and inpatient mortality. Significance was set at the P < 0.05 level.
resultsAmong 459,360 weighted admissions, 840 (0.18%) were dialysis-dependent. This cohort had a higher comorbidity burden (mean Elixhauser Index 4.33 versus 2.33; P < 0.001), was more often male, Black, and from lower-income areas. After adjustment, dialysis dependence was associated with increased odds of cardiovascular complications (OR 1.48; 95% CI 1.08–2.04), sepsis (OR 3.24; 95% CI 1.53–6.88), any adverse event (OR 1.59; 95% CI 1.16–2.18), non-routine discharge (OR 1.84; 95% CI 1.26–2.70), and inpatient mortality (OR 7.21; 95% CI 3.02–17.23). Mean hospital costs ($73,711 vs. $53,676; P = 0.003) and length of stay (9.76 vs. 4.41 days; P < 0.001) were higher in dialysis patients.
conclusionsDialysis-dependent patients undergoing multilevel lumbar fusion experience higher morbidity, prolonged hospitalization, and greater costs. While their odds of inpatient death are higher, absolute mortality in both groups was low. These findings underscore the need for targeted perioperative optimization and discharge planning in this high-risk group.
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