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Risk factors associated with repeated epidural blood patches using autologous blood
BACKGROUND: An epidural blood patch (EBP) is a procedure to treat intracranial hypotension that does not respond to conservative treatment. EBPs are commonly repeated when the symptoms persist. In this study, we used a large single-center retrospective cohort and evaluated the factors associated wit...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Pain Society
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8977201/ https://www.ncbi.nlm.nih.gov/pubmed/35354685 http://dx.doi.org/10.3344/kjp.2022.35.2.224 |
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author | Oh, Ah Ran Park, Jungchan Jeong, Ji Seon Lee, Jin Young Choi, Ji Won Kim, Hara Sim, Woo Seog |
author_facet | Oh, Ah Ran Park, Jungchan Jeong, Ji Seon Lee, Jin Young Choi, Ji Won Kim, Hara Sim, Woo Seog |
author_sort | Oh, Ah Ran |
collection | PubMed |
description | BACKGROUND: An epidural blood patch (EBP) is a procedure to treat intracranial hypotension that does not respond to conservative treatment. EBPs are commonly repeated when the symptoms persist. In this study, we used a large single-center retrospective cohort and evaluated the factors associated with repeated EBPs. METHODS: From January 2010 to December 2020, a total of 596 patients were treated with EBPs for intracranial hypotension. We evaluated the factors associated with repeated EBPs in the entire population, in patients with spontaneous intracranial hypotension (SIH), and in those with available myelographies. RESULTS: In a total of 596 patients, 125 (21.1%) patients required repeated EBPs, and 96/278 (34.5%) in SIH and 29/314 (9.2%) in iatrogenic population. In patients with SIH, international normalized ratio (INR) and cerebrospinal fluid (CSF) leakage on myelographies consistently exhibited significant associations (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.02–1.87; P = 0.043 and OR, 2.18; 95% CI, 1.28–3.69; P = 0.004). In patients with iatrogenic injury, INR and CSF leakage on myelogram did not show difference in repeated EBPs. CONCLUSIONS: Repeated EBPs may be more frequently required in patients with SIH. Prolonged INR and CSF leakage were associated with repeated EBPs in patient with SIH. Further studies are needed to determine factors associated with repeated EBP requirements. |
format | Online Article Text |
id | pubmed-8977201 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Korean Pain Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-89772012022-04-07 Risk factors associated with repeated epidural blood patches using autologous blood Oh, Ah Ran Park, Jungchan Jeong, Ji Seon Lee, Jin Young Choi, Ji Won Kim, Hara Sim, Woo Seog Korean J Pain Clinical Research Articles BACKGROUND: An epidural blood patch (EBP) is a procedure to treat intracranial hypotension that does not respond to conservative treatment. EBPs are commonly repeated when the symptoms persist. In this study, we used a large single-center retrospective cohort and evaluated the factors associated with repeated EBPs. METHODS: From January 2010 to December 2020, a total of 596 patients were treated with EBPs for intracranial hypotension. We evaluated the factors associated with repeated EBPs in the entire population, in patients with spontaneous intracranial hypotension (SIH), and in those with available myelographies. RESULTS: In a total of 596 patients, 125 (21.1%) patients required repeated EBPs, and 96/278 (34.5%) in SIH and 29/314 (9.2%) in iatrogenic population. In patients with SIH, international normalized ratio (INR) and cerebrospinal fluid (CSF) leakage on myelographies consistently exhibited significant associations (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.02–1.87; P = 0.043 and OR, 2.18; 95% CI, 1.28–3.69; P = 0.004). In patients with iatrogenic injury, INR and CSF leakage on myelogram did not show difference in repeated EBPs. CONCLUSIONS: Repeated EBPs may be more frequently required in patients with SIH. Prolonged INR and CSF leakage were associated with repeated EBPs in patient with SIH. Further studies are needed to determine factors associated with repeated EBP requirements. The Korean Pain Society 2022-04-01 2022-04-01 /pmc/articles/PMC8977201/ /pubmed/35354685 http://dx.doi.org/10.3344/kjp.2022.35.2.224 Text en © The Korean Pain Society, 2022 https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Research Articles Oh, Ah Ran Park, Jungchan Jeong, Ji Seon Lee, Jin Young Choi, Ji Won Kim, Hara Sim, Woo Seog Risk factors associated with repeated epidural blood patches using autologous blood |
title | Risk factors associated with repeated epidural blood patches using autologous blood |
title_full | Risk factors associated with repeated epidural blood patches using autologous blood |
title_fullStr | Risk factors associated with repeated epidural blood patches using autologous blood |
title_full_unstemmed | Risk factors associated with repeated epidural blood patches using autologous blood |
title_short | Risk factors associated with repeated epidural blood patches using autologous blood |
title_sort | risk factors associated with repeated epidural blood patches using autologous blood |
topic | Clinical Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8977201/ https://www.ncbi.nlm.nih.gov/pubmed/35354685 http://dx.doi.org/10.3344/kjp.2022.35.2.224 |
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