{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:10:50Z","timestamp":1771920650172,"version":"3.50.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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\u202fdays after open posterior lumbar fusion (OPLF) in elderly patients (\u2265 60\u202fyears old).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u202fdays 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the total, 8.6% (157\/1826) of elderly patients experienced unplanned readmission within 90\u202fdays 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\u202f&amp;lt;\u202f\u22123.5), 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 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.040, OR: 1.040, 95% CI: 1.002\u20131.079), ASA score \u2265 grade 3 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.022, OR: 1.634, 95% CI: 1.074\u20132.485), heart disease (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.021, OR: 1.971, 95% CI: 1.107\u20133.511), preoperative malnutrition (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.028, OR: 1.701, 95% CI: 1.058\u20132.734), severe osteoporosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.029, OR: 1.652, 95% CI: 1.054\u20132.588), surgical segment (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.020, OR: 1.521, 95% CI: 1.067\u20132.169), and incidental durotomy (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.012, OR: 2.193, 95% CI: 1.189\u20134.045) were risk factors for unplanned readmission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We identified seven risk factors associated with unplanned readmission within 90\u202fdays after OPLF in elderly patients. This information may assist clinicians in preoperative evaluations of patients to develop better surgical strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1653957","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T13:50:48Z","timestamp":1768312248000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for 90-day unplanned readmission after open posterior lumbar fusion in the elderly"],"prefix":"10.3389","volume":"16","author":[{"given":"Hao-Zhen","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Yantai Yuhuangding Hospital of Qingdao University","place":["Yantai, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Xiangyang No.1 People's Hospital, Hubei University of Medicine","place":["Xiangyang, Hubei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1016\/S0140-6736(18)32278-5","article-title":"Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the global burden of disease study 2017","volume":"392","year":"2018","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1016\/S0140-6736(18)31694-5","article-title":"Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories","volume":"392","author":"Foreman","year":"2018","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1177\/2192568218770769","article-title":"Degenerative lumbar spine disease: estimating global incidence and worldwide volume","volume":"8","author":"Ravindra","year":"2018","journal-title":"Global Spine J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1097\/BRS.0b013e3182833e7c","article-title":"Nationwide trends in the surgical management of lumbar spinal stenosis","volume":"38","author":"Bae","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/BRS.0000000000002822","article-title":"Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015","volume":"44","author":"Martin","year":"2019","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1016\/j.spinee.2020.05.558","article-title":"Recent trends in medicare utilization and reimbursement for lumbar spine fusion and discectomy procedures","volume":"20","author":"Lopez","year":"2020","journal-title":"Spine J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"E704","DOI":"10.1097\/BRS.0000000000003412","article-title":"Risk factors for 90-day readmissions with fluid and electrolyte disorders following posterior lumbar fusion","volume":"45","author":"Ranti","year":"2020","journal-title":"Spine"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s43390-021-00446-9","article-title":"Rates and risk factors associated with 30-and 90-day readmissions and reoperations after spinal fusions for adult lumbar degenerative pathology and spinal deformity","volume":"10","author":"Taliaferro","year":"2022","journal-title":"Spine Deform"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2875","DOI":"10.1007\/s00586-023-07662-z","article-title":"Risk factors for ninety-day readmissions following full-endoscopic transforaminal lumbar discectomy for 1542 patients in the biggest spine institutes in Korea","volume":"32","author":"Bae","year":"2023","journal-title":"Eur Spine J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e196","DOI":"10.1016\/j.wneu.2019.01.293","article-title":"Analysis of risk factors associated with hospital readmission within 360 days after degenerative lumbar spine surgery in elderly patients","volume":"126","author":"Lee","year":"2019","journal-title":"World Neurosurg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"131","DOI":"10.3171\/2016.12.SPINE16714","article-title":"Risk factors for 30-day reoperation and 3-month readmission: analysis from the quality and outcomes database lumbar spine registry","volume":"27","author":"Wadhwa","year":"2017","journal-title":"J Neurosurg Spine"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2015.7.FOCUS1534","article-title":"Thirty-day readmission rates in spine surgery: systematic review and meta-analysis","volume":"39","author":"Bernatz","year":"2015","journal-title":"Neurosurg Focus"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"412","DOI":"10.2106\/JBJS.21.00496","article-title":"The impact of social determinants of health on 30 and 90-day readmission rates after spine surgery","volume":"104","author":"Mohanty","year":"2022","journal-title":"J Bone Joint Surg Am"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e687","DOI":"10.1016\/j.wneu.2021.08.122","article-title":"Significance of hospital size in outcomes of single-level elective anterior cervical discectomy and fusion: a nationwide readmissions database analysis","volume":"155","author":"Shah","year":"2021","journal-title":"World Neurosurg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e227","DOI":"10.1016\/j.wneu.2021.05.080","article-title":"Prediction of major complications and readmission after lumbar spinal fusion: a machine learning-driven approach","volume":"152","author":"Shah","year":"2021","journal-title":"World Neurosurg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e19","DOI":"10.1016\/j.wneu.2021.02.114","article-title":"Predicting readmission after anterior, posterior, and posterior interbody lumbar spinal fusion: a neural network machine learning approach","volume":"151","author":"Kuris","year":"2021","journal-title":"World Neurosurg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1093\/neuros\/nyaa593","article-title":"Smoking is an independent risk factor for 90-day readmission and reoperation following posterior cervical decompression and fusion","volume":"88","author":"Badiee","year":"2021","journal-title":"Neurosurgery"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e360","DOI":"10.1016\/j.wneu.2021.02.021","article-title":"Influence of osteoporosis following spine surgery on reoperation, readmission, and economic costs: An 8-year Nationwide population-based study in Korea","volume":"149","author":"Lee","year":"2021","journal-title":"World Neurosurg"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e247","DOI":"10.1016\/j.wneu.2020.12.031","article-title":"Risk factors associated with 90-day readmissions following Occipitocervical fusion-a Nationwide readmissions database study","volume":"147","author":"Elia","year":"2021","journal-title":"World Neurosurg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"E23","DOI":"10.1097\/BRS.0000000000003753","article-title":"Cervical spinal fusion in adult patients with rheumatoid arthritis: a national analysis of complications and 90-day readmissions","volume":"46","author":"Fields","year":"2021","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/s00586-020-06541-1","article-title":"Factors associated with a 30-day unplanned readmission after elective spine surgery: a retrospective cohort study","volume":"30","author":"Oh","year":"2021","journal-title":"Eur Spine J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1093\/neuros\/nyy215","article-title":"Independent associations with 30-and 90-day unplanned readmissions after elective lumbar spine surgery: a national trend analysis of 144\u202f123 patients","volume":"84","author":"Elsamadicy","year":"2019","journal-title":"Neurosurgery"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"E857","DOI":"10.1097\/BRS.0000000000002995","article-title":"90-day readmission in elective primary lumbar spine surgery in the inpatient setting: a nationwide readmissions database sample analysis","volume":"44","author":"Rubel","year":"2019","journal-title":"Spine"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"E864","DOI":"10.1097\/BRS.0000000000003443","article-title":"90-day readmission rates for single level anterior lumbosacral interbody fusion: a Nationwide readmissions database analysis","volume":"45","author":"Elia","year":"2020","journal-title":"Spine"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2233","DOI":"10.2147\/RMHP.S388020","article-title":"Early readmission and reoperation after percutaneous Transforaminal endoscopic decompression for degenerative lumbar spinal stenosis: incidence and risk factors","volume":"15","author":"Wang","year":"2022","journal-title":"Risk Manag Healthc Policy"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1933","DOI":"10.1097\/BRS.0000000000001631","article-title":"Readmission rates, reasons, and risk factors in elderly patients treated with lumbar fusion for degenerative pathology","volume":"41","author":"Puvanesarajah","year":"2016","journal-title":"Spine"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1097\/BRS.0000000000001663","article-title":"Readmission rates, reasons, and risk factors following anterior cervical fusion for cervical spondylosis in patients above 65 years of age","volume":"42","author":"Puvanesarajah","year":"2017","journal-title":"Spine"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1016\/j.spinee.2020.01.003","article-title":"Rates and risk factors associated with 90-day readmission following cervical spine fusion surgery: analysis of the Michigan spine surgery improvement collaborative (MSSIC) registry","volume":"20","author":"Schafer","year":"2020","journal-title":"Spine J"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.spinee.2022.09.005","article-title":"Rates and reasons for reoperation within 30 and 90 days following cervical spine surgery: a retrospective cohort analysis of the Michigan spine surgery improvement collaborative (MSSIC) registry","volume":"23","author":"Patel","year":"2023","journal-title":"Spine J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1093\/neuros\/nyx063","article-title":"National Rates, causes, risk factors, and outcomes associated with 30-day and 90-day readmissions following degenerative posterior cervical spine surgery utilizing the Nationwide readmissions database","volume":"81","author":"Rumalla","year":"2017","journal-title":"Neurosurgery"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1177\/21925682221116823","article-title":"Risk factors for 30-day unplanned readmission following surgery for lumbar degenerative diseases: a systematic review","volume":"13","author":"Chen","year":"2023","journal-title":"Global Spine J"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1097\/BRS.0000000000000270","article-title":"Causes and risk factors for 30-day unplanned readmissions after lumbar spine surgery","volume":"39","author":"Pugely","year":"2014","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1016\/j.spinee.2012.09.051","article-title":"Thirty-day readmissions after elective spine surgery for degenerative conditions among US Medicare beneficiaries","volume":"12","author":"Wang","year":"2012","journal-title":"Spine J"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"40","DOI":"10.21037\/jss-23-89","article-title":"Development and validation of a point-of-care clinical risk score to predict surgical site complication-associated readmissions following open spine surgery","volume":"10","author":"Mueller","year":"2024","journal-title":"J Spine Surg"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1186\/s13018-022-03377-x","article-title":"Risk factors for ninety-day readmission following cervical surgery: a meta-analysis","volume":"17","author":"Wang","year":"2022","journal-title":"J Orthop Surg Res"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1097\/BRS.0000000000000759","article-title":"Unplanned hospital readmission after surgical treatment of common lumbar pathologies: rates and causes","volume":"40","author":"Akamnonu","year":"2015","journal-title":"Spine"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"262","DOI":"10.31616\/asj.2022.0073","article-title":"Effect of drain duration and output on perioperative outcomes and readmissions after lumbar spine surgery","volume":"17","author":"Karamian","year":"2023","journal-title":"Asian Spine J"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1227\/neu.0000000000002233","article-title":"Time of discharge and 30-day re-presentation to an acute care setting after elective lumbar decompression surgery","volume":"92","author":"Sastry","year":"2023","journal-title":"Neurosurgery"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"107017","DOI":"10.1016\/j.clineuro.2021.107017","article-title":"Effects of preoperative nutritional status on complications and readmissions after posterior lumbar decompression and fusion for spondylolisthesis: a propensity-score analysis","volume":"211","author":"Elsamadicy","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1186\/s13018-020-02051-4","article-title":"Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion","volume":"15","author":"He","year":"2020","journal-title":"J Orthop Surg Res"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1089\/sur.2023.051","article-title":"Role of pre-operative nutrition status on surgical site infection after posterior lumbar interbody fusion: a retrospective study","volume":"24","author":"Yang","year":"2023","journal-title":"Surg Infect"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1007\/s00586-019-05937-y","article-title":"A validated preoperative score for predicting 30-day readmission after 1-2 level elective posterior lumbar fusion","volume":"28","author":"Jain","year":"2019","journal-title":"Eur Spine J"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"21925682241250031","DOI":"10.1177\/21925682241250031","article-title":"The effect of osteoporosis on complications and reoperation rates after surgical management of adult thoracolumbar spinal deformity: a systematic review and meta analysis","volume":"14","author":"Lechtholz-Zey","year":"2024","journal-title":"Glob Spine J"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"E375","DOI":"10.1097\/BSD.0000000000000672","article-title":"What are the rates, reasons, and risk factors of 90-day hospital readmission after lumbar discectomy?: an institutional experience","volume":"31","author":"Kohls","year":"2018","journal-title":"Clin Spine Surg"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1653957\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T05:38:34Z","timestamp":1771911514000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1653957\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":44,"alternative-id":["10.3389\/fneur.2025.1653957"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1653957","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]},"article-number":"1653957"}}