Antiplatelet therapy is not associated with increased risk of complications after lumbar puncture.

IF 4.6 2区医学 Q1 CLINICAL NEUROLOGY Journal of Neurology Pub Date : 2024-12-24 DOI:10.1007/s00415-024-12864-6

Laura Stichaller, Nik Krajnc, Fritz Leutmezer, Elisabeth Stögmann, Friedrich Zimprich, Tobias Zrzavy, Thomas Berger, Gabriel Bsteh

{"title":"Antiplatelet therapy is not associated with increased risk of complications after lumbar puncture.","authors":"Laura Stichaller, Nik Krajnc, Fritz Leutmezer, Elisabeth Stögmann, Friedrich Zimprich, Tobias Zrzavy, Thomas Berger, Gabriel Bsteh","doi":"10.1007/s00415-024-12864-6","DOIUrl":null,"url":null,"abstract":"Background: Lumbar puncture (LP) is a critical diagnostic procedure in the evaluation of neurological diseases. Although considered safe, complications such as post-dural puncture headache (PDPH), back pain, subdural hematoma or venous sinus thrombosis may still occur. Whether the use of antiplatelet therapy (APT) increases the risk of complications after LP, remains unclear.Methods: This retrospective observational study included 783 patients who underwent diagnostic LP. We employed multivariate logistic regression models with complications as the dependent variable, and APT as the independent variable, adjusting for potential confounders.Results: Among 783 patients included (54.0% female, median age 48 years [IQR 33-64], median BMI 24.7 kg/m2 [IQR 21.8-28.3], 111 [14.2%] receiving APT), complications were observed in 182 (23.2%) patients. The most common complications were PDPH and back pain in 152 (19.4%) and 42 (5.4%) patients, respectively. Venous sinus thrombosis occurred in one (0.1%) patient. In the multivariate logistic regression model, younger age (OR 1.49 per 10 years, 95% CI 1.32-1.69, p < 0.001) and female sex (OR 1.74, 95% CI 1.19-2.54, p = 0.005) were associated with higher likelihood of complications, whereas APT (OR 0.63, 95% CI 0.30-1.36, p = 0.241) and the final diagnosis were not.Conclusion: Complications following LP occur in approximately one fourth of patients, with younger age and female sex being significant risk factors. As APT is not associated with increased risk of complications, withholding LP in patients on APT may not be necessary.","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 1","pages":"88"},"PeriodicalIF":4.6000,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668846/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00415-024-12864-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Lumbar puncture (LP) is a critical diagnostic procedure in the evaluation of neurological diseases. Although considered safe, complications such as post-dural puncture headache (PDPH), back pain, subdural hematoma or venous sinus thrombosis may still occur. Whether the use of antiplatelet therapy (APT) increases the risk of complications after LP, remains unclear.

Methods: This retrospective observational study included 783 patients who underwent diagnostic LP. We employed multivariate logistic regression models with complications as the dependent variable, and APT as the independent variable, adjusting for potential confounders.

Results: Among 783 patients included (54.0% female, median age 48 years [IQR 33-64], median BMI 24.7 kg/m² [IQR 21.8-28.3], 111 [14.2%] receiving APT), complications were observed in 182 (23.2%) patients. The most common complications were PDPH and back pain in 152 (19.4%) and 42 (5.4%) patients, respectively. Venous sinus thrombosis occurred in one (0.1%) patient. In the multivariate logistic regression model, younger age (OR 1.49 per 10 years, 95% CI 1.32-1.69, p < 0.001) and female sex (OR 1.74, 95% CI 1.19-2.54, p = 0.005) were associated with higher likelihood of complications, whereas APT (OR 0.63, 95% CI 0.30-1.36, p = 0.241) and the final diagnosis were not.

Conclusion: Complications following LP occur in approximately one fourth of patients, with younger age and female sex being significant risk factors. As APT is not associated with increased risk of complications, withholding LP in patients on APT may not be necessary.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

抗血小板治疗与腰椎穿刺后并发症风险的增加无关。

背景：腰椎穿刺（LP）是评估神经系统疾病的重要诊断手段。尽管被认为是安全的，但诸如硬膜穿刺后头痛（PDPH）、背痛、硬膜下血肿或静脉窦血栓形成等并发症仍可能发生。抗血小板治疗（APT）是否会增加LP术后并发症的风险尚不清楚。方法：本回顾性观察研究纳入783例诊断性LP患者。我们采用多变量logistic回归模型，以并发症为因变量，APT为自变量，调整潜在的混杂因素。结果：纳入的783例患者中（女性54.0%，中位年龄48岁[IQR 33-64]，中位BMI 24.7 kg/m2 [IQR 21.8-28.3]， 111例（14.2%）接受APT治疗），182例（23.2%）出现并发症。最常见的并发症是PDPH和背部疼痛，分别为152例（19.4%）和42例（5.4%）。1例（0.1%）患者发生静脉窦血栓形成。在多因素logistic回归模型中，年龄更小（OR为1.49 / 10年，95% CI为1.32-1.69,p）。结论：大约四分之一的患者发生LP并发症，年龄更小和女性性别是重要的危险因素。由于APT与并发症风险增加无关，因此在使用APT的患者中保留LP可能没有必要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.