Adjusted hazard rate ratios (HRs) were computed using Cox regression models. Secondary analyses included risks of traumatic lumbar puncture (>300 × 10 6 erythrocytes/L after excluding patients diagnosed with subarachnoid hemorrhage). Risks were provided as numbers and percentages with 95% CIs. Main Outcomes and Measures Thirty-day risk of spinal hematoma. Coagulopathy was defined as platelets lower than 150 × 10 9/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. Objective To determine the risk of spinal hematoma after lumbar puncture in patients with and without coagulopathy.ĭesign, Setting, and Participants 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). Importance Coagulopathy may deter physicians from performing a lumbar puncture. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Results of medical record review of all patients with diagnosis codes suggestive of spinal hematoma at departments of neurosurgery, neurology, or infectious diseases in North Denmark Region from 1998-2018 Flowchart of patients with lumbar puncture in the Danish Laboratory Database from 2008 to 2019ĮFigure 2. 30-day mortality rate and mortality rate ratios (MRR) in 83,711 lumbar punctures among 64,730 individuals with puncture in Denmark from 2008 to 2019ĮFigure 1. Risks of traumatic spinal tap following 61,568 lumbar punctures with measurement of cerebrospinal fluid erythrocytes in 46,459 individuals in Denmark from 2008 to 2019ĮTable 10. 30-day risk differences of spinal hematoma following 83,711 lumbar punctures in 64,730 individuals according to medical indication in Denmark from 2008 to 2019ĮTable 9. 30-day risks of spinal hematoma according to number of lumbar punctures in each personĮTable 8. Distribution of diagnosis codes indicating spinal hematoma after lumbar puncture in Denmark from 2008 to 2019ĮTable 7. Cross-tabulation of blood thrombocyte levels and international normalized ratio (INR) results in 83,711 lumbar punctures in 64,730 individuals in Denmark from 2008 to 2019ĮTable 6. Measurements of thrombocytes, international normalized ratio (INR), and activated partial thromboplastin time (APTT) in patients with and without spinal hematoma after lumbar puncture in Denmark from 2008 to 2019ĮTable 5. Diagnosis and surgical procedure codes used to identify patients admitted with spinal hematoma at departments of neurosurgery, neurology, or infectious diseases at Aalborg University Hospital, Aalborg, Denmark from 1998 through 2017ĮTable 4. Diagnosis and surgical procedure codes used in the Danish National Patient Registry and the Danish Registry of Causes of Death to identify patients with spinal hematoma and to compute the Charlson comorbidity scores of all study participants as well as the cause of deathĮTable 3. Nomenclature for Properties and Units codes for cerebrospinal fluid analyses used to identify individual lumbar punctures in the Danish Laboratory Database and at the Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, DenmarkĮTable 2.
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