Clinical review of the clinical necessity of lumbar punctures performed on adults at National District Hospital Emergency Department

South African Family Practice

Field Value
Title Clinical review of the clinical necessity of lumbar punctures performed on adults at National District Hospital Emergency Department
Creator Geldenhuys, Suné Boltman, Cecil Steinberg, Wilhelm J. Botes, Johan van Rooyen, Cornel
Subject — lumbar puncture; district hospital; prevalence; clinically indicated; necessity
Description Background: Previous studies have found that indications for lumbar punctures (LPs) are managed differently, which raises the question of whether all LPs performed are clinically necessary. This study aimed to determine whether unnecessary (clinically not indicated) LPs were being performed at a district hospital in the Free State, South Africa.Method: This was a retrospective descriptive study. A list from the National Health Laboratory Service (NHLS) was used to identify all patients on whom an LP was performed in the adult emergency department of National District Hospital (NDH) in Bloemfontein, from 1 January 2018 to 30 June 2018. Data were captured on a data sheet and included demographic information, clinical signs and symptoms the patients presented with and the cerebrospinal fluid results.Results: A total of 364 patients fit the inclusion criteria. Of these patients, 97 files (26.6%) could not be found, patient gender and LP results could be retrieved from the NHLS barcodes. After reviewing the presenting symptoms and signs captured on the 267 files, the primary researcher considered 150 (56.4%) of the LPs performed to have been carried out unnecessarily. From the total population of 364 patients, 246 (67.6%) of the LP results were normal. Only 118 (32.4%) of the LPs performed showed some form of central nervous system pathology. Of the 150 LPs assessed to have been unnecessarily performed, 124 (84.0%) were normal.Conclusion: This retrospective review indicates that a high percentage of LPs that were clinically not indicated were performed at NDH during the study period.
Publisher AOSIS
Contributor None
Date 2022-08-19
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Peer-reviewed Article —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/safp.v64i1.5435
Source South African Family Practice; Vol 64, No 1 (2022): Part 3; 8 pages 2078-6204 2078-6190
Language eng
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Rights Copyright (c) 2022 Suné Geldenhuys, Cecil Boltman, Wilhelm J. Steinberg, Johan Botes, Cornel van Rooyen