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Purpose <p>Lumbar spine decompression and fusion are commonly used to treat degenerative spinal disorders. Chronic thrombocytopenia (TCP) increases the hemorrhagic risk of some spinal surgeries; however, the effect of chronic TCP on lumbar fusion outcomes has not been comprehensively investigated. This study aimed to determine the impact of chronic TCP on the in-hospital outcomes of patients undergoing lumbar spinal fusion.</p> Methods <p>The United States (US) Nationwide Inpatient Sample (NIS) database was searched from 2005 to 2020 for in-patient data of patients ≥ 20 years who received lumbar fusion for lumbar degenerative disease. Patients with chronic TCP were matched to those without TCP in a 1:4 ratio using propensity score matching (PSM). The association between chronic TCP and in-hospital outcomes was determined using population-weighted logistic regression analyses.</p> Results <p>After PSM, 17,010 patients remained for analysis (3,402 with chronic TCP and 13,608 without). Multivariable analysis showed that chronic TCP was independently associated with higher risks of prolonged hospitalization (adjusted odds ratio [aOR] 2.50, 95% confidence interval [CI] 2.30–2.71), non-routine discharge (aOR 1.69, 95% CI 1.55–1.85), and any perioperative complication (aOR 4.14, 95% CI 3.82–4.50; all <i>p</i> &lt; 0.001).</p> Conclusions <p>Chronic TCP is an independent prognostic indicator for adverse outcomes in patients receiving fusion surgery for degenerative lumbar disease. These results highlight the vital need for the recognition and management of chronic TCP to mitigate risks in patients with degenerative spinal disorders.</p>

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Impact of chronic thrombocytopenia on outcomes after elective lumbar spine fusion: an analysis of the US nationwide inpatient sample

  • 期刊论文

  • 发表日期：

    2025年12月24日

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  • Yu-Chieh Huang,
  • Ko-chung Tsui,
  • Yih-Shien Chiang

摘要

Purpose

Lumbar spine decompression and fusion are commonly used to treat degenerative spinal disorders. Chronic thrombocytopenia (TCP) increases the hemorrhagic risk of some spinal surgeries; however, the effect of chronic TCP on lumbar fusion outcomes has not been comprehensively investigated. This study aimed to determine the impact of chronic TCP on the in-hospital outcomes of patients undergoing lumbar spinal fusion.

Methods

The United States (US) Nationwide Inpatient Sample (NIS) database was searched from 2005 to 2020 for in-patient data of patients ≥ 20 years who received lumbar fusion for lumbar degenerative disease. Patients with chronic TCP were matched to those without TCP in a 1:4 ratio using propensity score matching (PSM). The association between chronic TCP and in-hospital outcomes was determined using population-weighted logistic regression analyses.

Results

After PSM, 17,010 patients remained for analysis (3,402 with chronic TCP and 13,608 without). Multivariable analysis showed that chronic TCP was independently associated with higher risks of prolonged hospitalization (adjusted odds ratio [aOR] 2.50, 95% confidence interval [CI] 2.30–2.71), non-routine discharge (aOR 1.69, 95% CI 1.55–1.85), and any perioperative complication (aOR 4.14, 95% CI 3.82–4.50; all p < 0.001).

Conclusions

Chronic TCP is an independent prognostic indicator for adverse outcomes in patients receiving fusion surgery for degenerative lumbar disease. These results highlight the vital need for the recognition and management of chronic TCP to mitigate risks in patients with degenerative spinal disorders.