LP on an outpatient basis
While the volume of LPs being performed remain almost the same, there
has been an increasing trend to perform LPs on outpatient basis and in
the emergency setting and a decrease in the number of inpatient LP (
-37% in the study by kroll et al.,44,817 in 2011 vs 71,385 in
1991).30 Outpatient LPs can reduce the costs of
inpatient hospitalizations and also the duration of stay. However,
concern remain regarding the efficacy of outpatient primary care
providers and safety of outpatient LPs. Barreras et al. retrospectively
evaluated elective LPs performed at a resident-run University-Hospital
Outpatient LP Clinic between June 1, 2014, and May 31,
2015.31 A total of 282 patients underwent LP.
Successful acquisition of CSF was achieved in 267 (94.6 %) patients,
and the incidence of Post lumbar Puncture headache (PLPH) was 16%, the
same as accepted inpatient complication rate.31 Lambe
et al.32 and Popp et al.33 also
showed that the complication rate from outpatient LP was 4% and 9 %,
respectively, which were mild PLPH and did not require hospitalization.
So, a standardized approach via an outpatient LP clinic can have a high
rate of successful CSF acquisition and low rates for significant
post-procedure complications.