ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuroepidemiology
Risk factors for 90-day unplanned readmission after open posterior lumbar fusion in the elderly
Provisionally accepted
Hao-Zhen Lyu1
Lang Hu2*- 1Department of Spine Surgery, Yantai Yuhuangding Hospital, Yantai, China
- 2Department of Orthopedics, Xiangyang NO.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
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Background: The inescapable trend of an aging population has made lumbar fusion increasingly common in elderly individuals. This study aimed to explore the risk factors associated with unplanned readmission within 90 days after open posterior lumbar fusion (OPLF) in elderly patients (≥60 years old). Methods: We retrospectively analyzed clinical data of patients who underwent OPLF at two spine centers between June 2010 and June 2024. Patients were divided into readmission and non-readmission groups according to whether they were unplanned readmitted within 90 days of the primary surgery. Demographic and clinical outcomes were compared between the two groups. Multivariate logistic regression was used to analyze risk factors for 90-day readmission. Results: Of the total, 8.6% (157/1826) of elderly patients experienced unplanned readmission within 90 days of the initial surgery. Factors including age, body mass index (BMI), American Society of Anesthesiologists (ASA) score (grade 3), history of diabetes, heart disease, respiratory disease, preoperative malnutrition, severe osteoporosis (T < -3.5), incidental durotomy, surgical segment, and surgical time in the readmission group were significantly higher than those in the non-readmission group. Multivariate logistic regression analysis suggested that higher age (p = 0.040, OR: 1.040, 95% CI: 1.002–1.079), ASA score ≥grade 3 (p = 0.022, OR: 1.634, 95% CI: 1.074–2.485), heart disease (p = 0.021, OR: 1.971, 95% CI: 1.107–3.511), preoperative malnutrition (p = 0.028, OR: 1.701, 95% CI: 1.058–2.734), severe osteoporosis (p = 0.029, OR: 1.652, 95% CI: 1.054–2.588), surgical segment (p = 0.020, OR: 1.521, 95% CI: 1.067–2.169), and incidental durotomy (p = 0.012, OR: 2.193, 95% CI: 1.189–4.045) were risk factors for unplanned readmission. Conclusion: We identified seven risk factors associated with unplanned readmission within 90 days after OPLF in elderly patients. This information may assist clinicians in preoperative evaluations of patients to develop better surgical strategies.
Keywords: Elderly, Lumbar degenerative diseases, open posterior lumbar fusion, readmission within 90 days, Risk factors
Received: 25 Jun 2025; Accepted: 10 Dec 2025.
Copyright: © 2025 Lyu and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lang Hu
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