SHM Converge Scientific Abstract ePoster Gallery-Predictors of Successful Lumbar Punctures by a Medicine Procedure Service

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This observational study evaluated lumbar punctures (LPs) performed by a medicine procedure service (MPS) at the University of North Carolina from September 2015 to December 2020. The authors aimed to describe success rates and complications of LPs, with and without ultrasound guidance, and to identify factors linked to successful or traumatic procedures.<br /><br />A total of 1,065 LPs were performed in 844 patients. Trainees participated in most procedures (82.2%), and ultrasound guidance was used in 76.7%. Overall, CSF was obtained in 81.3% of LPs. Complications were uncommon: 7.8% were minor, and only 0.1% were major. About 15.2% of cases were deferred to neuroradiology, where the subsequent success rate was 84.8%. Traumatic LPs, defined by elevated CSF red blood cells, occurred in 11.1% of cases.<br /><br />On multivariable analysis, two factors were associated with lower odds of successful CSF acquisition: BMI ≥30 kg/m² and prior spinal surgery. In contrast, resident participation and requiring three needle passes were associated with higher odds of success. For traumatic LPs, ultrasound guidance and three needle passes were associated with lower odds of a traumatic tap.<br /><br />The study concludes that an MPS can achieve high LP success with low complication rates, even with frequent trainee involvement and widespread ultrasound use. Most procedures were completed at the bedside rather than referred to neuroradiology, suggesting potential cost savings. The findings may help institutions plan LP services, guide referral decisions, and support teaching and pre-procedure counseling.

Asset Subtitle

Erin M. Finn

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Author List Andrew Campbell, Andrew J. Donohoe, Andrew Short, Ann Marie Kumfer, Ashmita Chaterjee, Carlton Moore, David Hemsey, Emily Sturkie, Erin E. Dunneback, Erin M. Finn, Hillary B. Spangler, Jennifer McEntee, Jeremy Halbe, Jessica L. Guidici, John R. Steph

Category Research

Concept Lumbar Puncture

Concept Cerebrospinal Fluid

Concept Success Rate

Concept Traumatic Lumbar Puncture

Concept Complication Rate

Distinguished Non-Finalist

Presenter Organization University of North Carolina

Presenting Author Erin M. Finn

Track Patient Safety

Keywords

lumbar puncture

medicine procedure service

ultrasound guidance

success rate

complications

traumatic tap

cerebrospinal fluid

trainee participation

obesity

prior spinal surgery

Lumbar Puncture

Cerebrospinal Fluid

Success Rate

Traumatic Lumbar Puncture

Complication Rate