Ye Lulu, Geng Wenyan, Wang Jian, Tang Qiuyuan, Yang Qinfeng, Wang Qiongxiao, Fang Gang, Chen Yuhang, Pang Yuzhou
Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, Guangxi, China.
Department of Blood Transfusion, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Front Surg. 2025 Sep 3;12:1562714. doi: 10.3389/fsurg.2025.1562714. eCollection 2025.
Several studies have evaluated the influence of rheumatoid arthritis (RA) on postoperative results following lumbar fusion. Nonetheless, there is a lack of national-level data on the hospitalization costs and perioperative complications associated with RA patients who underwent lumbar fusion.
The Nationwide Inpatient Sample (NIS) database was analyzed from 2011 to 2019, focusing on individuals who received lumbar fusion procedures. Our retrospective study included 282,339 patients identified based on the International Classification of Diseases, Ninth and Tenth Editions (ICD-9/10). A comparative analysis was conducted using the outcomes of 8,993 patients with RA and 273,346 non-RA (NRA) patients. Propensity score matching was performed for the RA vs. NRA patients (1:2) in each procedure group to control for confounding demographic variables.
Patients with RA were notably older on average (64 years vs. 60 years in NRA, < 0.001) and had a higher proportion of females ( < 0.001). The RA cohort also experienced significantly longer hospital stays ( < 0.001) and higher hospital charges. Regarding perioperative complications, individuals with RA were significantly more likely to develop postoperative anemia (RA 22.2%vs. NRA 18.2%, < 0.001) and require blood transfusions (RA 11.7% vs. NRA 9.7%, < 0.001). No significant differences were observed in other recorded inpatient complications between RA and NRA patients.
Despite longer hospital stays and increased hospital charges, patients with RA did not show an increased risk of most in-hospital complications associated with lumbar fusion during the perioperative phase in the United States, except for postoperative anemia and the requirement for blood transfusions.
多项研究评估了类风湿关节炎（RA）对腰椎融合术后结果的影响。尽管如此，关于接受腰椎融合术的RA患者的住院费用和围手术期并发症，仍缺乏国家级数据。
分析2011年至2019年的全国住院患者样本（NIS）数据库，重点关注接受腰椎融合手术的个体。我们的回顾性研究纳入了根据国际疾病分类第九版和第十版（ICD - 9/10）确定的282,339例患者。对8993例RA患者和273,346例非RA（NRA）患者的结果进行了比较分析。在每个手术组中对RA与NRA患者（1:2）进行倾向得分匹配，以控制混杂的人口统计学变量。
RA患者的平均年龄明显更大（64岁 vs. NRA患者的60岁，<0.001），女性比例更高（<0.001）。RA队列的住院时间也明显更长（<0.001），住院费用更高。关于围手术期并发症，RA患者术后发生贫血的可能性显著更高（RA为22.2% vs. NRA为18.2%，<0.001），且需要输血的可能性也更高（RA为11.7% vs. NRA为9.7%，<0.001）。RA患者和NRA患者在其他记录的住院并发症方面未观察到显著差异。
尽管住院时间更长且住院费用增加，但在美国围手术期，除了术后贫血和输血需求外，RA患者与腰椎融合相关的大多数院内并发症风险并未增加。
