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Predictors Associated with Outcomes of Epidural Blood Patch in Patients with Spontaneous Intracranial Hypotension

An autologous epidural blood patch (EBP) is a mainstay of treatment in patients with spontaneous intracranial hypotension (SIH). EBP, however, is less effective for SIH than post-dural puncture headaches. Therefore, patients with SIH frequently require an additional EBP. The aim of this study was to...

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Autores principales: Park, Jun-Young, Ro, Young-Jin, Leem, Jeong-Gil, Shin, Jin-Woo, Oh, Yul, Choi, Seong-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957726/
https://www.ncbi.nlm.nih.gov/pubmed/33670838
http://dx.doi.org/10.3390/jcm10050922
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author Park, Jun-Young
Ro, Young-Jin
Leem, Jeong-Gil
Shin, Jin-Woo
Oh, Yul
Choi, Seong-Soo
author_facet Park, Jun-Young
Ro, Young-Jin
Leem, Jeong-Gil
Shin, Jin-Woo
Oh, Yul
Choi, Seong-Soo
author_sort Park, Jun-Young
collection PubMed
description An autologous epidural blood patch (EBP) is a mainstay of treatment in patients with spontaneous intracranial hypotension (SIH). EBP, however, is less effective for SIH than post-dural puncture headaches. Therefore, patients with SIH frequently require an additional EBP. The aim of this study was to identify factors associated with poor response to EBP. This single-center retrospective observational study used the institutional registry records of 321 patients who underwent EBP between September 2001 and March 2016. Patients were divided into two groups, a poor responder group, consisting of patients who underwent EBP at least three times or more, and a good responder group of patients who experienced sufficient symptom relief after two or fewer EBP. The demographic characteristics, clinical features, radiologic findings, procedural data, and laboratory data were analyzed. Univariate analysis showed that the neutrophil-to-lymphocyte ratio (NLR; p = 0.004) and platelet-to-lymphocyte ratio (p = 0.015) were significantly lower in poor than in good responders. Multivariate analysis found that NLR was the only independent factor associated with a poor response (odds ratio = 0.720; p = 0.008). These findings indicate that a low NLR was associated with three or more EBP administrations for the sufficient improvement of symptoms in patients with SIH.
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spelling pubmed-79577262021-03-16 Predictors Associated with Outcomes of Epidural Blood Patch in Patients with Spontaneous Intracranial Hypotension Park, Jun-Young Ro, Young-Jin Leem, Jeong-Gil Shin, Jin-Woo Oh, Yul Choi, Seong-Soo J Clin Med Article An autologous epidural blood patch (EBP) is a mainstay of treatment in patients with spontaneous intracranial hypotension (SIH). EBP, however, is less effective for SIH than post-dural puncture headaches. Therefore, patients with SIH frequently require an additional EBP. The aim of this study was to identify factors associated with poor response to EBP. This single-center retrospective observational study used the institutional registry records of 321 patients who underwent EBP between September 2001 and March 2016. Patients were divided into two groups, a poor responder group, consisting of patients who underwent EBP at least three times or more, and a good responder group of patients who experienced sufficient symptom relief after two or fewer EBP. The demographic characteristics, clinical features, radiologic findings, procedural data, and laboratory data were analyzed. Univariate analysis showed that the neutrophil-to-lymphocyte ratio (NLR; p = 0.004) and platelet-to-lymphocyte ratio (p = 0.015) were significantly lower in poor than in good responders. Multivariate analysis found that NLR was the only independent factor associated with a poor response (odds ratio = 0.720; p = 0.008). These findings indicate that a low NLR was associated with three or more EBP administrations for the sufficient improvement of symptoms in patients with SIH. MDPI 2021-02-28 /pmc/articles/PMC7957726/ /pubmed/33670838 http://dx.doi.org/10.3390/jcm10050922 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Park, Jun-Young
Ro, Young-Jin
Leem, Jeong-Gil
Shin, Jin-Woo
Oh, Yul
Choi, Seong-Soo
Predictors Associated with Outcomes of Epidural Blood Patch in Patients with Spontaneous Intracranial Hypotension
title Predictors Associated with Outcomes of Epidural Blood Patch in Patients with Spontaneous Intracranial Hypotension
title_full Predictors Associated with Outcomes of Epidural Blood Patch in Patients with Spontaneous Intracranial Hypotension
title_fullStr Predictors Associated with Outcomes of Epidural Blood Patch in Patients with Spontaneous Intracranial Hypotension
title_full_unstemmed Predictors Associated with Outcomes of Epidural Blood Patch in Patients with Spontaneous Intracranial Hypotension
title_short Predictors Associated with Outcomes of Epidural Blood Patch in Patients with Spontaneous Intracranial Hypotension
title_sort predictors associated with outcomes of epidural blood patch in patients with spontaneous intracranial hypotension
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957726/
https://www.ncbi.nlm.nih.gov/pubmed/33670838
http://dx.doi.org/10.3390/jcm10050922
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