A Retrospective Analysis on Complications, Readmissions, and Costs of Care in Patients Who Have Sarcoidosis Undergoing Single Level Primary Posterior Spinal Fusion: A Case-Matched Investigation of the PearlDiver Database

Purpose Research analyzing outcomes of patients with sarcoidosis undergoing primary single level posterior spinal fusion (PSF) is limited. The aims of this study were to determine if patients who have sarcoidosis undergoing PSF have higher: 1) complications; 2) readmissions; and 3) costs of care following PSF. Methods A retrospective case-matched level III investigation was performed using the PearlDiver database from 2010 to the first quarter of 2022. A 1:5 randomized matching was performed yielding 15,818 number of case (n = 2,640) and matched (n = 13,178) patients undergoing PSF. Multivariate analyses was used to compare the odds (OR) of developing medical complications and odds of being readmitted. Welch’s t- test were used to compare costs of care. A p- value less than 0.003 was considered statistically significant. Results Sarcoidosis patients had higher risk and odds of medical complications (34.77 vs. 16.96%; OR: 2.24, p <  0.0001) within 90-days following PSF such as pneumoniae (OR: 3.02, p <  0.0001), pulmonary emboli (OR: 2.67, p <  0.0001), cerebrovascular accidents (OR: 2.55, p <  0.0001), in addition to other complications. Ninety-day readmission rates were also significantly higher in the study cohort (11.06 vs. 5.35%; OR: 1.43, p <  0.0001), along with day of surgery ($17,420.85 vs. $16,229.48, p <  0.0001) and global 90-day interval ($22,676.69 vs. $20,323.00, p <  0.0001). Conclusion Sarcoidosis is associated with significantly higher rates and odds of medical complications following primary PSF, readmissions, and costs. The current investigation can help orthopaedists counsel patients who have sarcoidosis on the potential outcomes following their surgical procedure.