Recent Increase in the Rate of Spinal Infections May be Related to Growing Substance-Use Disorder in the State of Washington: Wide Population-based Analysis of the Comprehensive Hospital Abstract Reporting System (CHARS) Database.

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Spine (Phila Pa 1976)


STUDY DESIGN: Epidemiological study.

OBJECTIVE: To evaluate trends in the incidence of spinal infections and the possible role of substance use disorder as a key associated factor.

SUMMARY OF BACKGROUND DATA: Spinal infections (SI) pose major diagnostic and therapeutic challenge in developed countries, resulting in substantial morbidity and mortality. With an estimated incidence of up to 1:20,000, recent clinical experiences suggest that this rate may be rising.

METHODS: To evaluate a possible change in trend in the proportion of SI, we searched the Washington state Comprehensive Hospital Abstract Reporting System (CHARS) data over a period of 15 years. We retrieved ICD-9 and 10 codes, searching for all conditions that are regarded as SI (discitis, osteomyelitis and intra-spinal abscess), as well as major known SI-related risk factors.

RESULTS: We found that the proportion of SI among discharged patients had increased by more than 60% during the past 6 years, starting at 2012 and increasing steadily thereafter. Analysis of SI-related risk factors within the group of SI revealed that proportion of substance use disorder and malnutrition had undergone the most substantial change, with the former increasing more than 3-fold during the same period.

CONCLUSION: Growing rates of drug abuse, drug dependence and malnutrition throughout the State of Washington may trigger a substantial increase in the incidence of spinal infections in discharged patients. These findings may provide important insights in planning prevention strategies on a broader level.


Clinical Institute

Neurosciences (Brain & Spine)