Background Context: In the United States, the prevalence of inflammatory bowel disease (IBD) has increased concurrently with an aging population with degenerative disc changes. In these patients, primary 1- to 2-lumbar fusion (1-2LF) is a common procedure to resolve serious complications of the spine. Studies comparing these patient demographics to hospital lengths of stay, post-operative complications, readmission rates, and costs of care is limited in the literature.

Purpose: The purpose of this study was to determine whether IBD in patients with degenerative disc changes undergoing primary 1-2LF is associated with higher rates of: 1) in-hospital length of stay; 2) medical complications; 3) readmissions; and 4) costs of care.

Study Design/Setting: Retrospective Cohort Study

Patient Sample: The PearlDiver database was queried from 2010 to 2022 to identify patients who underwent primary 1- to 2- level lumbar fusion operations using International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM, ICD-10-CM) coding. Current Procedural Terminology (CPT) codes were also utilized to identify the patient cohort isolated.

Methods: A retrospective study using the PearlDiver database from the years 2010 to 2020 was performed to isolate IBD patients with degenerative disc disease undergoing primary 1-2LF. The inclusion criteria consisted of patients with IBD who underwent 1-2LF, using a 90-day surveillance period, post-operatively. This 90-day surveillance period was used to measure length of hospital stay, rates of medical complications, rates of readmissions, and overall costs of care. The IBD cohort was matched against a case-matched cohort group. The study yielded 20,640 patients, overall, with 3,446 IBD patients and 17,194 non-IBD patients. Baseline demographics were compared. Chi-Square Analyses were performed to properly match the two cohorts. Welch’s t-tests were used to test for significance for the length of stay and reimbursement data between both groups. Logistic regression analyses were utilized to calculate the odds-ratios (OR) and 95% confidence intervals (95%CI) to further analyze the association between IBD on post-operative outcomes after 1-2LF. Bonferroni adjustments were made and yielded an alpha value less than 0.001 as statistically significant. Finally, a p-value less than 0.05 was considered statistically significant.

Results: Patients in the study group had significantly longer in-hospital lengths of stay (4- vs. 3-days, p < 0.001). Additionally, patients in the study group had significantly higher incidence and odds of developing post-operative medical complications within 90 days (42.3% vs. 25.7%; OR: 1.73, p < 0.0001). Also, study group patients had significantly higher readmission rates (11.32% vs. 9.44%; OR: 1.22, p = 0.0007). Finally, patients in the study group had significantly higher costs of care than their case-matched cohort ($60,412.83 vs. $59,331.94, p < 0.0001).

Conclusions: This study demonstrated that patients with IBD and degenerative disc disease are burdened with longer in-hospital lengths of stay, rates of post-operative medical complications, rates of readmission, and costs of care after undergoing primary 1-2LF. Spine surgeons and other orthopaedic professionals would benefit from providing adequate counseling to this patient demographic so patients are fully aware of the potential post-operative burdens they may accrue.

Keywords: Lumbar Fusion; Inflammatory Bowel Disease; Degenerative Disc Disease

How Does Inflammatory Bowel Disease Impact Outcomes and Costs of CareFollowing Primary 1- to 2- Level Lumbar Fusion for Degenerative Disc Disease?

Clinical and Translational Research | Orthopaedic Surgery

poster

Welcome to the largest national, multi-specialty research event **featuring research from 750 medical students, residents and fellows, and international medical graduates.**


#### Event Details
The 2022 American Medical Association Research Challenge includes a poster symposium hall and a semifinals hall with the top scored research. Log in at any time throughout the event to:
* **View posters and presentations** on a variety of topics and specialties
* **Score posters in the semifinals** to help decide the top five finalists (AMA member exclusive opportunity)
* **Connect with participants** and provide feedback to help advance their research

At the conclusion of this event, the AMA will announce the top five finalists who will advance to the AMA Research Challenge finals, present their research to an elite panel of judges and compete to win a $10,000 grand prize sponsored by Laurel Road.
 

#### Attend Live Forums
**Oct. 20, 6 — 7 p.m. Central**
 **How to plan a career in academic medicine** 
 Learn how to plan a career in academic medicine and get your questions answered. [Access Here](https://underline.io/events/363/lounge)
 
 **Speakers**
![](https://assets.underline.io/uploads/markdown_image/1/image/d5adb133dfc58eb0a6d469e9cedcd5d4.jpg)
Ricardo Correa, MD, EdD
![](https://assets.underline.io/uploads/markdown_image/1/image/5f9437ab87861538bf02b9ca7c0d926e.jpg)
Stuart M. Greenstein, MD
![](https://assets.underline.io/uploads/markdown_image/1/image/05b1b637c99286d558c371f8e8b185ce.jpg)
Stephanie Strohbeen, MD
 
 **Oct. 22, 11 a.m. — Noon Central**
 **How to get published**
 Learn tips to get your research published and get your questions answered. [Access Here](https://underline.io/events/363/lounge)
 
 **Speakers**
![](https://assets.underline.io/uploads/markdown_image/1/image/8ce6235e957d31cb5e6f9097cc6f6972.jpg)
Jessica Li, MD/PhD Candidate
![](https://assets.underline.io/uploads/markdown_image/1/image/9950ef2e0237f54cb3d8280334d42491.jpg)
Charles Lopresto, DO

### Sponsor
AMA would like to thank Laurel Road for sponsoring a $10,000 grand prize for the winner of the AMA Research Challenge. Laurel Road is not involved in the judging or scoring process to select the winner. The winner will be announced on Dec. 7 during the AMA Research Challenge finals. Payment of the grand prize will be directly from Laurel Road. See the AMA Research Challenge Official Rules for terms and conditions.

![](https://assets.underline.io/uploads/markdown_image/1/image/611e331d4a0eba0920f240cfc04b4d77.png)

**There is no registration fee for this event! **

Register to explore research in a variety of topics. AMA members get exclusive access to score posters in the semifinals.

**Please use the link below to register for free if you have not already done so:**

https://www.ama-assn.org/about/events/ama-research-challenge

Registration Is Required

AMA Research Challenge 2022

Welcome to the largest national, multi-specialty research event featuring research from 750 medical students, residents and fellows, and international medical graduates.


Faisal Elali

1

Presentations

How Does Inflammatory Bowel Disease Impact Outcomes and Costs of CareFollowing Primary 1- to 2- Level Lumbar Fusion for Degenerative Disc Disease?

Stay up to date with the latest Underline news!

PRESENTATIONS

CONFERENCES

COMPANY

RESOURCES