A retrospective cohort analysis was conducted. For a study, the researchers sought to find any differences in postoperative outcomes and costs between outpatient and inpatient anterior lumbar interbody fusion (ALIF) and if any independent factors contributed to problems following outpatient ALIF. All patients under the age of 85 who underwent elective ALIF were included in the study (CPT-22558). Using the associated additional level fusion codes, patients were then separated into those who had single-level fusion and those who had multilevel fusion (CPT-22585). Finally, the resulting populations were divided into outpatient and inpatient cohorts using a service location modifier. Propensity score matching was used to account for selection bias; the inpatient and outpatient cohorts were matched based on age, sex, and the Charlson Comorbidity Index. The Bonferroni correction was employed for each multiple comparison (P<0.004), and statistical significance was defined at P less than 0.05. Both single-level and multilevel ALIF reduced the rate of medical problems in patients receiving outpatient procedures. Furthermore, age greater than 60, female sex, Charlson Comorbidity Index more significant than 3, chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, hypertension, and cigarette use were independent risk factors for higher complications. Finally, the cost of outpatient ALIF was $12,013 against $27,271 for inpatient ALIF (P<0.001). The outcomes added to the expanding body of evidence supporting the use of ALIF in the outpatient clinic for a carefully chosen group of patients.
