Epidemiology of lumbar punctures in hospitalized patients in the United States

OBJECTIVES: Lumbar puncture (LP) is an important technique for assessing and treating neurological symptoms. The objective of this study was to describe the characteristics of diagnostic lumbar punctures performed on hospitalized patients in the United States. METHODS: We analyzed data from the 2010 National Inpatient Sample (NIS) and the National Emergency Department Survey (NEDS). We included patients treated in the Emergency Department (ED) as well as those admitted to an inpatient bed through the ED. We identified patients undergoing LPs from ICD-9 procedural code 03.31 and CPT code 62270. We generated nationally weighted estimates of the total number of LPs. We also assessed patient and hospital characteristics of cases undergoing LP. RESULTS: Of an estimated 135 million hospitalizations (ED + admission, or ED only), there were an estimated 362,718 LPs (331,248–394,188), including 273,612 (251,850–295,375) among adults and 89,106 (71,870–106,342) among children (<18 years old). Of the 362,718 LPs, 136,764 (122,117–151,410) were performed in the ED without admission. The most common conditions associated with LP among children were fever of unknown origin, meningitis, seizures and other perinatal conditions. The most common conditions associated with LP among adults were headache and meningitis. CONCLUSIONS: Lumbar Puncture remains an important procedure for diagnostic and therapeutic uses in United States Hospitals.