Incidence and Associated Factors of Post dural puncture headache Among Adult Patients who undergone Lumbar puncture at University of Godar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia ,2024/2025

Abstract

Background: Lumbar puncture is a common and relatively safe procedure. Post‑dural puncture headache, is the most common complication of lumbar puncture after both diagnostic and therapeutic procedures. Post‑dural puncture headache can lead to serious complications, including cerebral venous thrombosis, subdural hematoma due to traction on the dural veins, seizures, herniation, coma, and even death. Although Post dural puncture is a common complication, many studies showed inconsistent finding and previous studies did not well address medical patients in the study area. Objective: To assess the incidence and associated factors of Post dural puncture among adult patients who undergone lumbar puncture at the University of Gondar Comprehensive Specialized Hospital, 2024/2025. Methods: Institution-based Prospective cohort study was conducted from October 1,2024 to January30, 2025, including a total of 400participants. Data were collected using semi structured questionnaire and patient chart and SPSS version 27 was used for analysis. Both bivariable and multivariable logistic regression analyses were used to identify factors associated with postdural puncture headache. Variables with a p-value less than 0.2 in the bivariable analysis were included in the multivariable analysis. Adjusted odds ratios with 95% confidence intervals were calculated to assess the strength of association. Variables with a pvalue less than 0.05 in multivariable logistic regression analysis were considered statistically significant. Result: The incidence of post dural puncture headache was 29% (95% CI: 24.5, 33.5).Low body mass index (AOR = 3; 95% CI: 1.42, 6.40), Large needle size (18 and 20G) ((AOR: 4.3, 95% CI: 2.12, 8.8) and (AOR: 2.41, 95% CI: 1.02, 5.7)), number of attempts (AOR = 2.8; 95% CI: 1.4, 5.8), and the volume of cerebrospinal fluid drained (AOR: 4.8, 95% CI: 2.5, 16.6) were significantly associated with post dural puncture headache. Conclusion and recommendation: Almost one third of participants were developed post dural puncture headache. Low body mass index, large needle size, number of attempts, and the volume of cerebrospinal fluid drained were significantly associated with post dural puncture headache. Thus,use of small needle size, minimize number of attempts and decrease the volume of CSF loss during lumbar puncture are recommended.