{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T23:57:28Z","timestamp":1793404648541,"version":"4.5.0"},"reference-count":53,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:00:00Z","timestamp":1725753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: While MRI is the primary diagnostic tool for the diagnosis of spondylodiscitis, the role of [18F]-fluorodeoxyglucose ([18F]FDG) PET\/CT is gaining prominence. This study aimed to determine the frequency of [18F]FDG PET\/CT usage and its impact on the in-hospital mortality rate in patients with spondylodiscitis, particularly in the geriatric population. Methods: We conducted a Germany-wide cross-sectional study from 2019 to 2021 using an open-access, Germany-wide database, analyzing cases with ICD-10 codes M46.2-, M46.3-, and M46.4- (\u2018Osteomyelitis of vertebrae\u2019, \u2018Infection of intervertebral disc (pyogenic)\u2019, and \u2018Discitis unspecified\u2019). Diagnostic modalities were compared for their association with in-hospital mortality, with a focus on [18F]FDG PET\/CT. Results: In total, 29,362 hospital admissions from 2019 to 2021 were analyzed. Of these, 60.1% were male and 39.9% were female, and 71.8% of the patients were aged 65 years and above. The overall in-hospital mortality rate was 6.5% for the entire cohort and 8.2% for the geriatric subgroup (p &lt; 0.001). Contrast-enhanced (ce) MRI (48.1%) and native CT (39.4%) of the spine were the most frequently conducted diagnostic modalities. [18F]FDG PET\/CT was performed in 2.7% of cases. CeCT was associated with increased in-hospital mortality (OR = 2.03, 95% CI: 1.90\u20132.17, p &lt; 0.001). Cases with documented [18F]FDG PET\/CT showed a lower frequency of in-hospital deaths (OR = 0.58, 95% CI: 0.18\u20130.50; p = 0.002). This finding was more pronounced in patients aged 65 and above (OR = 0.42, 95% CI: 0.27\u20130.65, p = 0.001). Conclusions: Despite its infrequent use, [18F]FDG PET\/CT was associated with a lower in-hospital mortality rate in patients with spondylodiscitis, particularly in the geriatric cohort. This study is limited by only considering data on hospitalized patients and relying on the assumption of error-free coding. Further research is needed to optimize diagnostic approaches for spondylodiscitis.<\/jats:p>","DOI":"10.3390\/antibiotics13090860","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T05:59:08Z","timestamp":1725861548000},"page":"860","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["[18F]FDG PET\/CT Imaging Is Associated with Lower In-Hospital Mortality in Patients with Pyogenic Spondylodiscitis\u2014A Registry-Based Analysis of 29,362 Cases"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0459-9092","authenticated-orcid":false,"given":"Siegmund","family":"Lang","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0654-2076","authenticated-orcid":false,"given":"Nike","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7708-5864","authenticated-orcid":false,"given":"Stefanie","family":"Heidemanns","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7536-2207","authenticated-orcid":false,"given":"Constantin","family":"Lapa","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Faculty of Medicine, University of Augsburg, 86154 Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5050-0316","authenticated-orcid":false,"given":"Melanie","family":"Schindler","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Krueckel","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6910-8843","authenticated-orcid":false,"given":"Nils Ole","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3056-0143","authenticated-orcid":false,"given":"Dirk","family":"Hellwig","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0208-4650","authenticated-orcid":false,"given":"Volker","family":"Alt","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7221-3783","authenticated-orcid":false,"given":"Markus","family":"Rupp","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E102","DOI":"10.1097\/BSD.0000000000000597","article-title":"The Epidemiology of Vertebral Osteomyelitis in the United States From 1998 to 2013","volume":"31","author":"Issa","year":"2018","journal-title":"Clin. 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