In this Danish cohort study, risk of spinal hematoma following lumbar puncture was 0.20% among patients without coagulopathy and 0.23% among those with coagulopathy. If your level is too low, you may need to increase your medication dose. Why do you need a PT/INR test A PT/INR test measures how well you’re responding to warfarin (Coumadin) or another blood thinner. If you’re taking medication that affects how your blood clots, your INR will be higher than 1.1. Risks did not increase significantly according to overall severity of coagulopathy, in subgroup analyses of severity of coagulopathy by pediatric specialty or medical indication (infection, neurological condition, and hematological malignancy), nor by cumulative number of procedures. A normal INR value is between 0.8 and 1.1. Independent risk factors for spinal hematoma were male sex (adjusted hazard ratio, 1.72 95% CI, 1.15-2.56), those aged 41 through 60 years (adjusted HR, 1.96 95% CI, 1.01-3.81) and those aged 61 through 80 years (adjusted HR, 2.20 95% CI, 1.12-4.33). Follow-up was complete for more than 99% of the study participants. Thrombocytopenia was present in 7875 patients (9%), high INR levels in 1393 (2%), and prolonged APTT in 2604 (3%). Results: A total of 83 711 individual lumbar punctures were identified among 64 730 persons (51% female median age, 43 years ) at the time of the procedure. Adjusted hazard rate ratios (HRs) were computed using Cox regression models. The most common symptoms are headache, nausea, vomiting and seizures. ![]() Secondary analyses included risks of traumatic lumbar puncture (>300 × 106 erythrocytes/L after excluding patients diagnosed with subarachnoid hemorrhage). Hydrocephalus is caused by a build-up of cerebrospinal fluid in your brain. Risks were provided as numbers and percentages with 95% CIs. Main outcomes and measures: Thirty-day risk of spinal hematoma. Hydrocephalus is the symptomatic accumulation of cerebrospinal fluid (CSF) inside the cerebral ventricles. Coagulopathy was defined as platelets lower than 150 × 109/L, international normalized ratio (INR) greater than 1.4, or activated partial thromboplastin time (APTT) longer than 39 seconds.Įxposures: Coagulopathy at the time of lumbar puncture. Danish nationwide, population-based cohort study using medical registries to identify persons who underwent lumbar puncture and had cerebrospinal fluid analysis (January 1, 2008-Decemfollowed up through October 30, 2019).
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