Risk Factors Associated with Postoperative Cerebrospinal Fluid Leaks After Intrathecal Drug Delivery System and an External Pump Implantation in Cancer Patients: A Retrospective Study.

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY
Pain and Therapy Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI:10.1007/s40122-024-00608-3
Yuan Li, Shuwu Zhao, Keith Candiotti, Chen Su
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引用次数: 0

Abstract

Introduction: To determine risk factors associated with postoperative cerebrospinal fluid leaks (CSFLs) after intrathecal drug delivery system (IDDS) and external pump implantation.

Methods: The clinical data of 248 patients with advanced cancer who underwent IDDS implantation from January 2021 to December 2022 at the Department of Pain Medicine at the Hunan Cancer Hospital were retrospectively reviewed. Information regarding age, gender, height, weight, body mass index (BMI), tumour type, albumin levels, haemoglobin levels, history of diabetes and pre- and postoperative anti-tumour therapy was collected and analysed.

Results: Postoperative CSFLs occurred in 7 of 231 patients (3.30%). Statistical analysis indicated that gender, age, height, weight, BMI, tumour type, albumin levels, haemoglobin levels, history of diabetes, pre- and postoperative chemotherapy, pre- and postoperative radiotherapy, preoperative immunotherapy and postoperative targeted therapy were not independent factors for CSFLs. Preoperative targeted therapy [odds ratio (OR): 16.64; 95% confidence interval (CI): 1.42, 195.56; P = 0.01] and postoperative immunotherapy (OR: 13.38; 95% CI: 1.60, 111.65; P = 0.017) were factors associated with an increased postoperative CSFL rate. Of the two locations where CSFLs can occur, the back (puncture site of catheter, n = 4) and the hypochondriac region (location of infusion port implanted, n = 3), back CSFLs occurred earlier than in the hypochondriac region (18.25 ± 6.45 vs 115 ± 62.02 days, P = 0.032).

Conclusion: Based on the data from our study, the timing of preoperative targeted therapy and postoperative immunotherapy should be considered to prevent the occurrence of CSFLs in cancer pain patients who have an IDDS and external pump.

Abstract Image

癌症患者鞘内给药系统和外泵植入术后脑脊液漏的相关风险因素:一项回顾性研究
简介:目的:确定术后脑脊液漏(CSFL)的相关风险因素:方法:回顾性分析2021年1月至2022年12月在湖南省肿瘤医院疼痛科接受IDDS植入术的248例晚期癌症患者的临床资料:方法:回顾性分析湖南省肿瘤医院疼痛科2021年1月至2022年12月期间248例接受IDDS植入术的晚期癌症患者的临床资料。收集并分析了患者的年龄、性别、身高、体重、体重指数(BMI)、肿瘤类型、白蛋白水平、血红蛋白水平、糖尿病史和术前术后抗肿瘤治疗等信息:结果:231 例患者中有 7 例(3.30%)发生了术后 CSFL。统计分析表明,性别、年龄、身高、体重、BMI、肿瘤类型、白蛋白水平、血红蛋白水平、糖尿病史、术前和术后化疗、术前和术后放疗、术前免疫治疗和术后靶向治疗不是导致 CSFL 的独立因素。术前靶向治疗[几率比 (OR):16.64;95% 置信区间 (CI):1.42, 195.56;P = 0.01]和术后免疫治疗(OR:13.38;95% CI:1.60, 111.65;P = 0.017)是术后 CSFL 发生率增加的相关因素。在可能发生 CSFL 的两个部位,即背部(导管穿刺部位,n = 4)和下腹部(输液孔植入位置,n = 3),背部 CSFL 的发生时间早于下腹部(18.25 ± 6.45 vs 115 ± 62.02 天,P = 0.032):根据我们的研究数据,应考虑术前靶向治疗和术后免疫治疗的时机,以防止使用 IDDS 和外泵的癌痛患者发生 CSFL。
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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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