Gerstmeyer Julius, Pierre Clifford, Patel Neel, Davis Donald David, Pluemer Jonathan, Schildhauer Thomas A, Abdul-Jabbar Amir, Oskouian Rod J, Chapman Jens R
Swedish Neuroscience Institute, Swedish Medical Center, 550 17th Avenue, Suite 500, Seattle, WA, 98122, USA.
Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
Eur Spine J. 2025 Apr 26. doi: 10.1007/s00586-025-08790-4.
The rising incidence of spondylodiscitis (SD) poses a challenge to healthcare systems worldwide. Treatment approaches are inconsistent, devoid of standardized algorithms and lack evidence-based guidelines. To date there is a knowledge gap relative to treatment, readmission rates and efficacy for different SD management strategies. This study aims to assess the 90-day all-cause readmission rates for SD relative to treatment pathways.
Using the 2020 Nationwide Readmissions Database we screened adult patients (> 18 years) for primary diagnosis of SD by ICD-10 Codes. Demographic/clinical data, and treatments was extracted. The cohort was divided into two groups by treatment at initial admission. Descriptive and comparative analysis, with a multivariate regression to identify independent risk factors for readmission, were performed.
Out of 6,139 patients, 1,258 patients (20.5%) receiving surgical treatment. The overall, readmission rate was 35%. Surgically treated patients had a significantly lower readmission rate and a shorter time to readmission (29.3%; 41.65 days (± 22.84)). Those receiving surgical care during both stays (0.8%) had the longest time to readmission at 50.85 days (± 24.27). A change in treatment upon readmission was observed in 8.4%. Surgical management at index admission was identified as a protective factor against readmission.
SD management remains challenging. We showed that primary surgical treatment of SD resulted in a significantly lower readmission rate with a longer time interval until readmission compared to non-surgically treatment. Surgery at initial admission was identified as a protective factors against readmission. A more definitive initial approach towards SD might lower unexpected readmissions.
脊椎椎间盘炎（SD）发病率的上升给全球医疗系统带来了挑战。治疗方法不一致，缺乏标准化算法且没有循证指南。迄今为止，在不同SD管理策略的治疗、再入院率和疗效方面存在知识空白。本研究旨在评估与治疗途径相关的SD患者90天全因再入院率。
利用2020年全国再入院数据库，我们通过ICD - 10编码筛选出成年患者（>18岁）作为SD的初步诊断对象。提取人口统计学/临床数据及治疗情况。该队列在初次入院时按治疗方式分为两组。进行描述性和比较性分析，并采用多变量回归来确定再入院的独立危险因素。
在6139例患者中，1258例患者（20.5%）接受了手术治疗。总体再入院率为35%。接受手术治疗的患者再入院率显著较低，再入院时间较短（29.3%；41.65天（±22.84））。两次住院期间均接受手术治疗的患者（0.8%）再入院时间最长，为50.85天（±24.27）。8.4%的患者在再入院时治疗方式发生了改变。初次入院时的手术治疗被确定为预防再入院的保护因素。
SD的管理仍然具有挑战性。我们发现，与非手术治疗相比，SD的初次手术治疗导致再入院率显著降低，且再入院间隔时间更长。初次入院时进行手术被确定为预防再入院的保护因素。对SD采取更明确的初始治疗方法可能会降低意外再入院率。
