Prevalence, risk factors of mortality, and clinical outcomes in patients with spontaneous spinal infection

Purpose: Identifying the risk factors for spontaneous spinal infection is the main purpose. Methods: A retrospective chart review revealed patients with spinal infection following for one year, excluding the patients who had received spinal surgery before the diagnosis. There were 340 patients enrolled to the study with spontaneous spondylodiscitis during the period between January, 2014 and December, 2021, which had received full clinical assessment, laboratory test, radiological study and clinical management. MRI was performed for the initial diagnosis and up to 12 months of following. Results: Among the 340 patients with an average age of 63 years, 40 patients expired due to the infection within 12 months of diagnosis, of which 5 patients received surgical intervention compared to 97 patients for the survival group. Univariable logistic regression analysis demonstrated hypertension [OR: 2.44 (1.21-4.91), p = 0.013], renal impairment [OR: 2.97 (1.45-6.12), p = 0.003], without surgical intervention [OR: 3.35 (1.27-8.00), p = 0.014], hemoglobin [OR: 0.77 (0.67-0.90), p = 0.001], and CRP [OR: 1.03 (0.99-1.07), p = 0.061]. While multivariable logistic regression analysis demonstrated renal impairment [OR: 2.95 (1.39-6.27), p = 0.005], without surgical intervention [OR: 2.99 (1.11-8.07), p = 0.030] as the independent factors. Conclusions: Impaired renal function and surgical intervention were identified as predictors of one-year mortality in patients with spondylodiscitis. However, a number of additional novel and potentially important factors warrant consideration, including obesity, variations in pathogen source, poor nutritional status and inflammatory marks.