LUMBER PUNCTURE AND ASSOCIATED FACTORS AMONG PARENTS OF CHILDREN HOSPITALIZED WITH SUSPECTED CENTRAL NERVOUS SYSTEM INFECTONS

Abstract

Lumber Puncture (LP) can be performed for both diagnostic and therapeutic purposes. Failure to perform LP is associated with greater morbidity and mortality due to delayed diagnosis and improper management. This study was conducted to evaluate frequency of LP refusal and its associated factors among parents of children hospitalized with suspected Central Nervous System (CNS) infections. This cross-sectional study was conducted from October 2021 to April 2022 at National Institute of Child Health (NICH), Karachi, Pakistani. Parents/attendants of all pediatric patients hospitalized with suspected CNS infections and advised LP by the treating physicians were included in the study. A semi-structured questionnaire was used to assess the perception and attitude of patients’ towards the procedure and if they agreed for their child to undergo LP. Parents of 338 children were enrolled, out of which 203(60.1%) consented for LP. Majority refused because of fear of complications followed by those who believed LP was not required (29%). Common misconceptions regarding LP complications were risk of death (13%), epilepsy (11%) and paralysis (7%). Significantly lower refusals were observed when no other course was offered as alternate to LP (p-value <0.001). There was high frequency of LP refusal among parents of pediatric patients presenting with suspected CNS infections, most important cause of refusal was fear of complications.