ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1562714
This article is part of the Research TopicDiagnosis and Treatment in Age-related musculoskeletal disordersView all 13 articles
The impact of rheumatoid arthritis on perioperative complications and hospit alization costs of lumbar fusion: A national analysis
Provisionally accepted
Lulu Ye1Wenyan Geng2
Jian Wang3Qiuyuan Tang1
Qinfeng Yang3Qiongxiao Wang1Gang Fang1Yuhang Chen4*
Yuzhou Pang1*- 1Guangxi University of Chinese Medicine, Nanning, Guangx, China
- 2Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
- 3Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
- 4The First People’s Hospital of Foshan, Foshan, China
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Background: Several studies have evaluated the influence of rheumatoid arthritis (RA) on postoperative results following lumbar fusion. Nonetheless, there is a lack of nationallevel 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 8993 patients with RA and 273,346 non-RA (NRA) patients.Propensity score matching was performed for the RA versus NRA patients (1:2) in each procedure group to control for confounding demographic variables.Results: Patients with RA were notably older on average (64 years vs. 60 years in NRA, P < 0.001) and had a higher proportion of females (P < 0.001). The RA cohort also experienced significantly longer hospital stays (P < 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%, P < 0.001) and require blood transfusions (RA 11.7% vs. NRA 9.7%, P < 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 associ ated with lumbar fusion during the perioperative phase in the United States, exce pt for postoperative anemia and the requirement for blood transfusions.
Keywords: Lumbar fusion, Rheumatoid arthritis, complications, Hospitalization costs, The Nationwide Inpatient Sample database
Received: 13 Feb 2025; Accepted: 24 Jul 2025.
Copyright: © 2025 Ye, Geng, Wang, Tang, Yang, Wang, Fang, Chen and Pang. 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:
Yuhang Chen, The First People’s Hospital of Foshan, Foshan, China
Yuzhou Pang, Guangxi University of Chinese Medicine, Nanning, 530001, Guangx, China
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