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Objective: Spondylodiscitis presents a significant diagnostic and treatment challenge to healthcare providers, with various risk factors and treatment outcomes having been identified. Malnutrition, a multifactorial condition defined by imbalance or deficiency of nutrients, is a known risk factor for various adverse events such as postoperative infection and readmissions in spine surgery. However, its impact in SD has not yet been explored. The study aims to assess the prevalence of malnutrition and hypoalbuminemia in SD patients and their impact on the 90-day-all-cause readmission and in-hospital mortality rates.

Methods: Using the 2020 Nationwide Readmission Database, adult patients were selected by primary ICD-10 diagnosis for SD (M46.2x, M46.3x and M46.4x). Demographic information and clinical data were extracted. Readmissions were identified by VisitLink. Patients were categorized into 2 groups: those with malnutrition and/or hypoalbuminemia and those without. Descriptive and comparative analysis, with multivariate regression models to assess for independent risk factors of mortality and readmission were performed.

Results: In total 5,731 patients met the inclusion criteria, with 13% (n=767) identified as malnourished and 1.7% (n=96) with hypoalbuminemia.Patients with malnutrition had significantly higher 90-day all-cause readmission rates and in-hospital mortality compared to the control group.

Among others, malnutrition was associated with a 25% increased risk of readmission and more than double the risk of mortality.

Conclusion: Malnutrition and hypoalbuminemia are relatively common in SD patients and are significant risk factors for both in-hospital mortality and readmission. Early identification, including screening for hypoalbuminemia and management of malnutrition, may be beneficial in SD treatment.