ArticleFrontiers in medicine2026
In-hospital events and resource utilization associated with percutaneous-based vs. open lumbar fusion, stratified by admission status: a national inpatient sample analysis.
Article in Frontiers in medicine, 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
Minimally invasive surgery (MIS) may be associated with a more favorable short-term inpatient profile after lumbar fusion, but whether these associations differ by admission status remains unclear. In this retrospective observational analysis of repeated cross-sectional 2016-2022 National Inpatient Sample (NIS) discharge data, hospitalizations of adults undergoing lumbar fusion were identified and stratified as elective or non-elective. The exposure was defined by the International Classification of Diseases, Tenth Revision, Procedure Coding System-coded approach as percutaneous-based (percutaneous/percutaneous-endoscopic) vs. open fusion. Survey-weighted multivariable logistic regression accounted for the NIS's complex design and adjusted for demographics, hospital characteristics, fusion extent, indication/case-mix, and individual Elixhauser comorbidities; formal approach-by-admission interactions were tested. A total of 174,704 hospitalizations met the inclusion criteria. In elective admissions, percutaneous-based fusion was associated with lower odds of blood product transfusion (aOR 0.448, 95% CI 0.311-0.644), acute posthemorrhagic anemia (aOR 0.591, 95% CI 0.475-0.736), and prolonged length of stay (aOR 0.774, 95% CI 0.656-0.914). In non-elective admissions, it was associated with lower odds of acute posthemorrhagic anemia (aOR 0.669, 95% CI 0.491-0.912) and non-home discharge (aOR 0.666, 95% CI 0.502-0.883). Significant approach-by-admission interactions were observed for blood product transfusion (
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