Lumbar puncture practice in case of hemorrhagic or ischemic risk: a national opinion survey

• Published in: Revue neurologique Vol. 170; no. 11; pp. 685 - 692
• Main Authors: Heitz, C, Lorette, A, Julian, A, Roubaud, C, Paquet, C
• Format: Journal Article
• Language: French
• Published: France 01-11-2014
• Subjects: Adult; Anticoagulants - adverse effects; Female; France; Health Care Surveys; Hemorrhage - epidemiology; Humans; Internet; Ischemia - epidemiology; Male; Platelet Aggregation Inhibitors - adverse effects; Platelet Count; Risk; Spinal Puncture - adverse effects; Spinal Puncture - methods; Spinal Puncture - statistics & numerical data; Surveys and Questionnaires; Thrombosis - epidemiology; France; Antiplatelet; Coagulation disorders; Risque thrombotique; Trouble de la coagulation; Ponction lombaire; Haemorrhagic risk; Antiagrégants plaquettaires; Anticoagulant; Risque hémorragique; Thrombotic risk; Lombar puncture; Anticoagulatants
• ISSN: 0035-3787
• DOI: 10.1016/j.neurol.2014.05.007

Lumbar puncture (LP) is a common medical procedure for which no valid consensus exists in situations of hemorrhagic or thrombotic risk. The aim of this study was to identify the opinion-guided practices of LP at a national level.
A national opinion survey on Internet. An anonymous questionnaire of 19 questions collecting information about the LP practice for patients with hemorrhagic or thrombotic risks.
We sent 632 e-mails with the link of the survey and obtained 211 responses in six weeks. None of the responses was unanimous for any of the 13 different clinical situations proposed. Six practices were reported as adopted by the majority of participants, six by more than one-third. Reports of practices were highly variable, particularly for the minimum platelets count accepted, for the management of patients taking two antiplatelet agents or newer anticoagulant agents.
These results underline the heterogeneity of practices and the lack of recommendations. The establishment of a clear consensus in this area seems essential to guide practices in the future. In order to increase the representativeness of our responses, the survey is still going on online and will be open for all practitioners who wish to participate (http://www.surveymonkey.com/s/hemopl).