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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Bibliographic Details
Published in:Journal of clinical medicine 2021-02, Vol.10 (5), p.922
Main Authors: Park, Jun-Young, Ro, Young-Jin, Leem, Jeong-Gil, Shin, Jin-Woo, Oh, Yul, Choi, Seong-Soo
Format: Article
Language:English
Subjects:
Bladder
Blood
Blood platelets
Clinical medicine
Epidural
Headaches
Hypotension
Laboratories
Lymphocytes
Magnetic resonance imaging
Medical records
Neutrophils
Pain
Patients
Radioisotopes
Regression analysis
Remission (Medicine)
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Summary: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; = 0.004) and platelet-to-lymphocyte ratio ( = 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; = 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.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10050922