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Comparison of the Safety of Inpatient versus Outpatient Lumbar Fusion: A Systematic Review and Meta-Analysis – Lumbar Fusion

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The article is a systematic review and meta-analysis that aims to analyze the safety profile of outpatient lumbar fusion. The study utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched for relevant studies comparing outcomes of inpatient and outpatient lumbar fusion cohorts. The analysis included 14 publications with a total of 75,627 patients. The results showed that outpatient cohorts had significantly decreased odds of medical and surgical complications compared to inpatient cohorts. There were no significant differences in readmission or revision surgery between the two groups. Patient reported outcome measures were largely similar, with a few studies showing better outcomes among outpatient cohorts. The study concluded that preliminary data suggests a favorable safety profile in appropriately selected patients, but more research, particularly prospective and randomized trials, is needed to definitively change practice

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spinal hospital in London

Published article

: Preliminary data regarding the safety of outpatient lumbar fusion demonstrates a favorable safety profile in appropriately selected patients, with patient reported outcomes remaining comparable in this setting. There is no data in the form of prospective and randomized trials which is necessary to definitively change practice.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine (Phila Pa 1976). 2023 Sep 28. doi: 10.1097/BRS.0000000000004838. Online ahead of print.ABSTRACTSTUDY DESIGN: Systematic Review and Meta-Analysis.OBJECTIVE: The objective of this study is to synthesize the early data regarding and analyze the safety profile of outpatient lumbar fusion.SUMMARY OF BACKGROUND DATA: Preforming lumbar fusion in an outpatient or ambulatory setting is becoming an increasingly,

Spine (Phila Pa 1976). 2023 Sep 28. doi: 10.1097/BRS.0000000000004838. Online ahead of print.

ABSTRACT

STUDY DESIGN: Systematic Review and Meta-Analysis.

OBJECTIVE: The objective of this study is to synthesize the early data regarding and analyze the safety profile of outpatient lumbar fusion.

SUMMARY OF BACKGROUND DATA: Preforming lumbar fusion in an outpatient or ambulatory setting is becoming an increasingly employed strategy to provide effective value-based care. As this is an emerging option for surgeons to employ in their practices, the data is still in its infancy.

METHODS: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that described outcomes of inpatient and outpatient lumbar fusion cohorts were searched from PubMed, Medline, The Cochrane Library, and Embase. Rates of individual medical and surgical complications, readmission, and reoperation were collected when applicable. Patient reported outcomes were additionally collected if reported. Individual pooled comparative meta-analysis was performed for outcomes of medical complications, surgical complications, readmission, and reoperation. Patient reported outcomes were reviewed and qualitatively reported.

RESULTS: The search yielded 14 publications that compared outpatient and inpatient cohorts with a total of 75,627 patients. Odds of readmission demonstrated no significant difference between outpatient and inpatient cohorts (OR=0.94 [0.81 – 1.11]). Revision surgery similarly was no different between the cohorts (OR=0.81 [0.57 – 1.15]). Pooled medical and surgical complications demonstrated significantly decreased odds for outpatient cohorts compared to inpatient cohorts (OR=0.58 [0.34 – 0.50]OR=0.41 [0.50 – 0.68] respectively). Patient reported outcome measures were largely the same between the cohorts when reported, with few studies showing better ODI and VAS-Leg outcomes among outpatient cohorts compared to inpatient cohorts.

: Preliminary data regarding the safety of outpatient lumbar fusion demonstrates a favorable safety profile in appropriately selected patients, with patient reported outcomes remaining comparable in this setting. There is no data in the form of prospective and randomized trials which is necessary to definitively change practice.

PMID:37767789 | DOI:10.1097/BRS.0000000000004838

The London Spine Unit : innovative spinal hospital in London

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Comparison of the Safety of Inpatient versus Outpatient Lumbar Fusion: A Systematic Review and Meta-Analysis

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Spine (Phila Pa 1976). 2023 Sep 28. doi: 10.1097/BRS.0000000000004838. Online ahead of print.ABSTRACTSTUDY DESIGN: Systematic Review and Meta-Analysis.OBJECTIVE: The objective of this study is to synthesize the early data regarding and analyze the safety profile of outpatient lumbar fusion.SUMMARY OF BACKGROUND DATA: Preforming lumbar fusion in an outpatient or ambulatory setting is becoming an increasingly
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