To identify demographic, clinical, and socioeconomic predictors of all-cause hospital readmissions following spinal cord infarction (SCI) using a large, nationally representative dataset.

Spinal cord infarction (SCI) is an uncommon yet severe neurological emergency, representing roughly 1–2% of all ischemic strokes. The condition often results in long-term motor, sensory, and autonomic deficits that substantially affect quality of life and healthcare utilization. Although previous studies have described acute management and short-term outcomes, national data evaluating post-discharge readmissions are limited. Recognizing factors that increase readmission risk may help clinicians design targeted care pathways and reduce healthcare burden in this rare population.

The Nationwide Readmissions Database (NRD) was queried from 2016 through 2022 to identify adult patients (≥18 years) with a primary diagnosis of SCI. Multivariable logistic regression was used to evaluate independent predictors of 90-day all-cause readmission. Demographic variables, comorbidities, and SCI-related complications were included. Variables significant in univariable testing were retained in the final model. Results were reported as odds ratios (OR) with 95% confidence intervals (CI).

A total of 3,321 primary SCI hospitalizations were identified; 27% (95% CI: 24–30%) resulted in readmission within 90 days. Patients with private insurance and those in the highest income quartile had lower odds of readmission. In contrast, autonomic dysfunction (OR = 5.44, 95% CI: 1.86–15.94), renal disease (OR = 3.57, 95% CI: 1.83–6.96), and liver disease (OR = 2.40, 95% CI: 1.34–4.32) were associated with significantly higher odds.

In this nationwide analysis, both clinical and socioeconomic factors were associated with readmission risk after SCI. Autonomic dysfunction and renal disease emerged as strong clinical predictors, while lower income and public insurance status contributed to increased vulnerability. These findings underscore the need for multidisciplinary approaches and targeted follow-up strategies to reduce preventable readmissions and improve outcomes after spinal cord infarction.