263EMF Epidemiology of Lumbar Punctures in Hospitalized Patients in United States

Lumbar puncture (LP) is an important technique for assessing and treating neurological symptoms. The current epidemiology of LPs for hospitalized patients is unknown. The objective of this study was to describe the characteristics of for lumbar punctures among hospitalized patients in the United States. We analyzed 2010 US ED visit data from the National Emergency Department Sample. We identified all ED patient visits associated with the performance of an LP. We identified LPs using ICD-9-CM procedure code 03.31 and Current Procedural Terminology code and Healthcare Common Procedure Coding System (CPT/HCPCS) procedure code 62270. In addition to primary diagnoses, we characterized LP patient characteristics and LP hospital characteristics. Using descriptive statistical techniques, we calculated the number and incidence of LPs performed in the United States emergency departments in 2010. Of an estimated 135 million ED visits, the estimated numbers of LP were: 362,718, including 273,612 (75%) among adult hospitalizations and 89,106 (25%) among pediatric hospitalizations. Among children, over 18% of LPs were performed on hospitalized patients 0-5 years old. Of the LPs performed 136,764 (38%) were known to have occurred in the ED. The most common conditions associated with LP among children were fever of unknown origin, other perinatal conditions meningitis and seizures and among adults were headache and meningitis. Lumbar puncture is a continued important procedure for diagnostic and therapeutic uses in United States hospitals.