# Beyond the Spine: Exploring Mental Health Disorders in Spondylodiscitis

## TL;DR

This study finds that mental health disorders are common in patients with spondylodiscitis and are linked to higher hospital readmission rates, especially for substance-related disorders.

## Contribution

The study is the first to investigate the impact of mental health disorders on spondylodiscitis outcomes using a national database.

## Key findings

- Mental health disorders were present in 61.4% of spondylodiscitis patients.
- Substance-related disorders significantly increased 90-day readmission risk.
- Depression and anxiety were common but not significant predictors of readmission.

## Abstract

Background/Objectives: Spondylodiscitis (SD) is a challenging and multifaceted condition with increasing incidences globally. Mental health disorders (MHDs) are well recognized for their negative impacts on outcomes. To our knowledge, the effects of MHDs on SD have not been studied. This study aims to assess the incidence of MHDs in patients hospitalized for SD, and their impact on 90-day all-cause readmission rates using the Nationwide Readmission Database (NRD). Methods: A retrospective analysis using the 2020 NRD was performed. Adult patients were selected by primary ICD-10 codes for SD. MHDs were defined by ICD-10 F-codes. Demographic and clinical data were extracted, and readmissions were identified using VisitLinks. Patients were stratified based on MHD presence, with statistical analyses conducted to identify independent risk factors for readmission. Results: Of a total of 6139 patients, 3771 (61.4%) had an MHD. The overall 90-day readmission rate was 35%, with MHD patients experiencing a significantly higher rate (36.1%). Substance-related disorders, particularly opioid (OR 1.187, p = 0.019) and alcohol use disorders (OR 1.310, p = 0.020), were independently associated with increased readmission risk. Although common, depression, anxiety, schizophrenia, and personality disorders were not significant predictors. Conclusions: MHDs are prevalent among SD patients and are associated with an increased risk of hospital readmission, particularly in those with substance-related disorders. Integrating mental health interventions into SD management may improve patient outcomes. This study is limited by the use of an administrative database, which may lead to potential under-reporting of clinical variables. Future research may explore targeted interventions to optimize care for this high-risk population.