Michael W. Fields, Nathan J. Lee, Jacob R. Ball, Venkat Boddapati, Justin Mathew, Daniel Hong, Josephine R. Coury, Zeeshan M. Sardar, Benjamin Roye, Michael Vitale, Lawrence G. Lenke

March 2021, Volume 30, Issue 3, pp 775 - 787 Original Article Read Full Article 10.1007/s00586-020-06645-8

First Online: 19 October 2020


The purpose of this study was to utilize the National Readmission Database (NRD) to determine estimates for complication rates, 90-day readmission rates, and hospital costs associated with spinal fusion in pediatric patients with Marfan syndrome.


The 2012–2015 NRD databases were queried for all pediatric (


A total of 249 patients with Marfan syndrome underwent spinal fusion surgery between 2012 and 2015 (mean age ± standard deviation at the time of surgery: 14 ± 2.0, 132 (53%) female). 25 (10.1%) were readmitted within 90 days of the index hospital discharge date. Overall, 59.7% of patients experienced at least one complication during the index admission. Unplanned 90-day readmission could be predicted by older age (odds ratio 2.3, 95% confidence interval 1.3–4.2, p = 0.006), Medicaid insurance status (56.0, 3.8–820.0, p = 0.003), and experiencing an inpatient medical complication (42.9, 4.6–398.7, p = 0.001). Patients were readmitted for wound dehiscence (8 patients, 3.2%), nervous system related complications (3 patients, 1.2%), and postoperative infectious related complications (4 patients, 1.6%).


This study is the first to demonstrate on a national level the complications and potential risk factors for 90-day hospital readmission for patients with Marfan syndrome undergoing spinal fusion. Patients with Marfan syndrome undergoing spinal fusion often present with multiple medical comorbidities that must be managed carefully perioperatively to reduce inpatient complications and early hospital readmissions.

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