Impact of Renal Osteodystrophy on In-Hospital Outcomes Following Cervical Fusion: A National Inpatient Sample Study

Area of Science:

• Nephrology
• Orthopedic Surgery
• Critical Care Medicine

Background:

• Renal osteodystrophy (ROD) is a common complication in chronic kidney disease patients.
• Cervical fusion is a complex surgical procedure with potential for significant perioperative morbidity.

Purpose of the Study:

• To investigate the association between ROD and in-hospital outcomes in patients undergoing cervical fusion.
• To evaluate the impact of ROD on complications and resource utilization post-cervical fusion.

Main Methods:

• Retrospective cross-sectional analysis of the National Inpatient Sample (2016-2022).
• Propensity score matching to compare patients with and without ROD undergoing cervical fusion.
• Multivariable logistic regression and analysis of length of stay and hospital charges.

Main Results:

• ROD was linked to increased mechanical ventilation, delirium, thrombocytopenia, and transfusion requirements.
• Patients with ROD experienced longer hospital stays and higher total charges compared to non-ROD patients.
• Sensitivity analysis confirmed persistent associations for delirium and transfusion, with attenuated mechanical ventilation signal.

Conclusions:

• ROD is associated with a greater burden of perioperative complications and increased hospital resource utilization after cervical fusion.
• Patients with ROD may require intensified perioperative risk stratification and multidisciplinary care, focusing on bleeding and delirium.
• Further research into optimizing care pathways for ROD patients undergoing spinal surgery is warranted.