{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:00:30Z","timestamp":1790589630935,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To update national estimates of in-hospital mortality after lumbar fusion, characterize when deaths occur during hospitalization, and identify independent predictors of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adult (\u226518\u00a0years) lumbar fusion hospitalizations in the National Inpatient Sample (NIS) from 2016 to 2022 were analyzed. The primary outcome was in-hospital mortality. Secondary outcomes included hospital-day timing of death and survivor\u2013decedent comparisons of comorbidity and perioperative complication profiles. Multivariable logistic regression identified independent predictors (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1,181,465 weighted admissions, mortality was 0.11% (1290 deaths) and occurred early (approximately 50% within 7 days; &gt;90% by \u223c 30\u00a0days). Decedents more often underwent multilevel fusion (67.8% vs 38.8%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), were aged \u226575\u00a0years (41.5% vs 16.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and had higher comorbidity burden (mean Elixhauser count 3.92 vs 2.15,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Independent predictors included age \u226575 years (OR 4.49,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003), multilevel fusion (OR 2.09,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), congestive heart failure (OR 4.46,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), coagulopathy (OR 3.44,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), neurologic disorders (OR 9.27,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), peripheral vascular disease (OR 1.61,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.031), and higher comorbidity count (per-point OR 1.16,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.010). Female sex (OR 0.72,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.022) and highest income quartile (OR 0.58,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009) were protective.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In-hospital mortality after lumbar fusion is uncommon but concentrates early and disproportionately affects older, medically complex patients undergoing multilevel procedures, supporting preoperative counseling, front-loaded perioperative risk stratification, and heightened early postoperative vigilance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261423475","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T11:23:39Z","timestamp":1770204219000},"page":"3129-3138","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["In-Hospital Mortality After Lumbar Fusion is Rare But Occurs Early: A Nationwide Analysis of Risk Factors, 2016-2022"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-055X","authenticated-orcid":false,"given":"Mitchell K.","family":"Ng","sequence":"first","affiliation":[{"name":"Rothman Orthopaedic Institute, Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8926-3502","authenticated-orcid":false,"given":"Leonidas E.","family":"Mastrokostas","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-517X","authenticated-orcid":false,"given":"Paul G.","family":"Mastrokostas","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"},{"name":"Maimonides Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton J.","family":"Cristofoli","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Xie","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregorio","family":"Baek","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Thomas Jefferson University 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