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Lumbar puncture seems to be safe and practical ın oldest-old patients: a protocol from a memory center
Mehmet Selman Ontan1, Fatma Sena Dost1, Derya Kaya1
1Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Purpose:
Physicians may hesitate to perform lumbar puncture (LP) with advancing age, particularly in daily practice in those aged 80 years or older. This study aimed to evaluate the characteristics and complications of LP in the oldest-old.
Methods:
The medical records of all the patients who underwent LP in a geriatrics inpatient memory clinic were retrospectively reviewed with a specified protocol. As well as demographics, indication for LP, position during the procedure, the total number of LP attempts, the volume of CSF removed, post-LP headache (PLPH), and post-LP back pain at the LP site (PLPBP) were also obtained from the patients' files. The patients were divided into two groups based on their ages as older adults and oldest-old adults.
Results:
In this study, a total of 202 LPs were included, of which 39.6% were performed in those aged ≥ 80. PLPH was detected in 6.9% and PLPBP in 7.4% of all our patients, while the rates were 7.5% and 6.3% in the oldest-old group.The frequency of PLPH and PLPBP, the number of traumatic LP procedures, and repeated LP attempts were similar. between the groups. In regression analysis, only the medical history of headache was correlated with PLPH, as well as nonspecific headache, and intracranial hypotension. PLPBP was associated with the number of LP attempts (≥ 3).
Conclusion:
In the oldest old, lumbar puncture is as safe as in younger-older adults when it is performed in experienced geriatric clinics with the specified protocol.
