Risk factors associated with repeated epidural blood patches using autologous blood

Ah Ran Oh; Jungchan Park; Ji Seon Jeong; Jin Young Lee; Ji Won Choi; Hara Kim; Woo Seog Sim

doi:10.3344/kjp.2022.35.2.224

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자료유형: 학술저널

저자정보: Ah Ran Oh (Sungkyunkwan University School of Medicine) Jungchan Park (Sungkyunkwan University School of Medicine) Ji Seon Jeong (Sungkyunkwan University School of Medicine) Jin Young Lee (Sungkyunkwan University School of Medicine) Ji Won Choi (Sungkyunkwan University School of Medicine) Hara Kim (Sungkyunkwan University School of Medicine) Woo Seog Sim (Sungkyunkwan University School of Medicine)

저널정보: 대한통증학회 The Korean Journal of Pain The Korean Journal of Pain 제35권 제2호

발행연도: 2022.4

수록면: 224 - 230 (7page)

DOI: 10.3344/kjp.2022.35.2.224

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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.

#Blood Patch #Epidural #Cerebrospinal Fluid Leak #Headache #Intracranial Hypotension #Pain Management #Patient Outcome Assessment #Post-Dural Puncture Headache #Therapeutics.

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