¹Department of Orthopedics and Trauma Surgery, St. Josef Hospital Bochum, Bochum, Deutschland
²Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Deutschland
³Swedish Neuroscience Institute, Seattle, USA
⁴Seattle Science Foundation, Seattle, USA
⁵Department of Orthopedics and Trauma Surgery, St. Josef Hospital Essen-Werden, Universitaetsmedizin Essen, Essen, Deutschland

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Objective: Spondylodiscitis (SD) is a challenging and multidirectional condition with increasing incidences globally. Diagnostic improvements and an aging and multimorbid population contribute to this trend. In another domain, incidences and prevalence of mental health disorders (MHD) have risen sharply. Regarding spine surgery MHD such as depression, anxiety and schizophrenia are well recognized to have negative effects on outcomes. Furthermore MHD can impact the immune response, potentially making patients more susceptible to infections. To our knowledge the effects of MHD on SD have not been studied. We aim to assess the incidence of MHD in patients hospitalized for SD and their impact on 90 days all cause readmission rate by utilizing the Nationwide Readmission Database.

Methods: Utilizing the 2020 Nationwide Readmissions Database a retrospective analysis was performed. Adult patients were selected by primary International Classification of Diseases 10 (ICD-10) codes for SD. Mental health disorders were defined by ICD-10 F-codes. Demographic information and clinical data were extracted. Readmissions were identified using the VisitLink. The cohort was divided into two groups by presence of MHD. Descriptive and comparative analysis were performed. A multivariate regression analysis was used to identify independent risk factors for readmission.

Results: A total of 6,139 patients met our inclusion criteria with 3,771 (61.4%) suffering from a MHD. The all-cause 90-day readmission rate was 35%. Patients with MHD had a significantly higher readmission rate in a shorter time compared to those without MHD (36.1% vs. 33.2%).

Although depression and anxiety disorders were the most frequent diagnoses, they were not significantly different in their prevalence between patients who were readmitted and those who were not. Alcohol and opioid related disorders were identified as independent risk factors for readmission.

Conclusion: Patients suffering from mental health disorders are common in SD and significantly more likely to be readmitted in a shorter time. Dependency disorders were identified as independent risk factors for readmission whereas specific disorders such as depression, anxiety, schizophrenia and personality disorder did not affect the rate of readmission. Integrating treatment for MHD into the standard care of SD may improve patients’ outcome.