Parameters Related to Lumbar Puncture Do not Affect Occurrence of Postdural Puncture Headache but Might Influence Its Clinical Phenotype.
Headache
Lumbar puncture
Post-dural puncture headache
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
29
08
2019
revised:
15
09
2019
accepted:
16
09
2019
pubmed:
29
9
2019
medline:
25
1
2020
entrez:
29
9
2019
Statut:
ppublish
Résumé
Post-dural puncture headache (PDPH) has been the most common complication of diagnostic and therapeutic lumbar puncture (LP). The occurrence and clinical features of PDPH in relationship to different demographic, clinical, and paraclinical parameters and parameters related to LP were assessed. We conducted a cohort, prospective, single-center study of 252 consecutive patients (105 men and 147 women; average age, 47.3 ± 15.0 years), who had undergone LP for different medical reasons from February 2018 to June 2018 at the Clinic for Neurology Clinical Center of Serbia (Belgrade, Serbia). Of the 252 patients, PDPH was reported in 133 (52.8%). The incidence of PDPH was more frequent in women (64.7%; P = 0.043). Univariate analyses identified the following significant risk factors for PDPH: female gender (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.05-2.89), age (OR, 0.95; 95% CI, 0.94-0.97), smoking duration (OR, 0.91; 95% CI, 0.88-0.95), preexisting headaches (OR, 2.40; 95% CI, 1.39-4.17), circulatory system disease (OR, 0.52; 95% CI, 0.29-0.92), and musculoskeletal system and connective tissue disease (OR, 0.31; 95% CI, 0.12-0.81). In the multivariable model, duration of smoking and preexisting headaches remained independent risk factors for PDPH (OR, 0.93; 95% CI, 0.88-0.97; P = 0.002; and OR, 4.23; 95% CI, 1.27-14.08; P = 0.019, respectively). For various PDPH characteristics, significant risk factors were identified, including age, female gender, body mass index, circular or endocrine system diseases, and the use of caffeinated drinks before LP. In addition, the caliber of the traumatic needle, direction and number of needle stitches during LP, occurrence, intensity, and radiation of pain during LP, volume of sampled cerebrospinal fluid, rest and hydration after LP, preexisting headache, and earlier PDPH were significant. All these models were well-calibrated (Hosmer-Lemeshow test, P > 0.05). The results of the present study are important for the prediction of the occurrence of PDPH and the differential diagnosis of headaches after LP.
Sections du résumé
BACKGROUND
BACKGROUND
Post-dural puncture headache (PDPH) has been the most common complication of diagnostic and therapeutic lumbar puncture (LP). The occurrence and clinical features of PDPH in relationship to different demographic, clinical, and paraclinical parameters and parameters related to LP were assessed.
METHODS
METHODS
We conducted a cohort, prospective, single-center study of 252 consecutive patients (105 men and 147 women; average age, 47.3 ± 15.0 years), who had undergone LP for different medical reasons from February 2018 to June 2018 at the Clinic for Neurology Clinical Center of Serbia (Belgrade, Serbia).
RESULTS
RESULTS
Of the 252 patients, PDPH was reported in 133 (52.8%). The incidence of PDPH was more frequent in women (64.7%; P = 0.043). Univariate analyses identified the following significant risk factors for PDPH: female gender (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.05-2.89), age (OR, 0.95; 95% CI, 0.94-0.97), smoking duration (OR, 0.91; 95% CI, 0.88-0.95), preexisting headaches (OR, 2.40; 95% CI, 1.39-4.17), circulatory system disease (OR, 0.52; 95% CI, 0.29-0.92), and musculoskeletal system and connective tissue disease (OR, 0.31; 95% CI, 0.12-0.81). In the multivariable model, duration of smoking and preexisting headaches remained independent risk factors for PDPH (OR, 0.93; 95% CI, 0.88-0.97; P = 0.002; and OR, 4.23; 95% CI, 1.27-14.08; P = 0.019, respectively). For various PDPH characteristics, significant risk factors were identified, including age, female gender, body mass index, circular or endocrine system diseases, and the use of caffeinated drinks before LP. In addition, the caliber of the traumatic needle, direction and number of needle stitches during LP, occurrence, intensity, and radiation of pain during LP, volume of sampled cerebrospinal fluid, rest and hydration after LP, preexisting headache, and earlier PDPH were significant. All these models were well-calibrated (Hosmer-Lemeshow test, P > 0.05).
CONCLUSION
CONCLUSIONS
The results of the present study are important for the prediction of the occurrence of PDPH and the differential diagnosis of headaches after LP.
Identifiants
pubmed: 31562971
pii: S1878-8750(19)32515-X
doi: 10.1016/j.wneu.2019.09.085
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e540-e550Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.