자발성 두개내 저압증 환자에서 시행하는 경막외 자가 혈액 봉합술의 결과에 미치는 예후 인자에 관련한 연구

Abstract

Spontaneous intracranial hypotension (SIH) is recognized resulted by low cerebrospinal fluid pressure. An autologous epidural blood patch (EBP) in SIH treatment now widely accepted as a mainstay interventional treatment. Although its favor effectiveness, a single EBP often requires additional EBP delivering because of inadequate response in single trial. The aim of this study was to find out an associated factor of EBP outcome to estimate this additional EBP requirement. This single-center retrospective observational study used the institutional registry records of 321 patients who experienced epidural blood patch between September 2001 and March 2016. We divided the SIH patients into two groups according to their response upon EBP; an immediate responder and a delayed responder group. An immediate responder group showed their sufficient symptoms relieving 2times or less attempting EBP, on the other hand delayed responder group showed 3 times or more attempting EBP. Between the two groups, statistical differences in basic demographic characteristics were not found. There are many estimated associated factors for example; brain image, epidural blood patch site, laboratory data including platelet to lymphocyte ratio or neutrophil lymphocyte (NLR) ratio. Consequently, only the NLR showed statistical meaning. We reveal an elevated NLR ratio is an associated factor to favor outcome in multivariate logistic regression analysis.