Influence of antithrombotic medication on size and neurological outcome of spinal epidural hematoma after neuraxial anesthesia: a systematic review
Authors' conclusion
Antithrombotic medication is not significantly associated with hematoma size; however, the use of antithrombotic medication doubled the risk for persistent neurological deficit after spinal epidural hematoma.
Study context
- Population
- Cases of spinal epidural hematoma following neuraxial anesthesia304 publications
- Participants
- 345 cases
- Comparison
- Antithrombotic medication vs none; non-guideline adherent vs guideline adherent puncture/removal
- Outcome
- Segmental extension (hematoma size) and neurological outcome
Methodological detailsprespecified multivariate regression, propensity score matching
- Prespecified multivariate regression
- Propensity score matching
Pooled result
As reported in the abstract
Hematoma size (segmental extension) and persistent neurological deficit
Odds ratio (95% CI)P value
Antithrombotic medicationpersistent neurological deficit; after propensity score matching p=0.04
2.00(1.24–3.23)
P < 0.01- Antithrombotic medication · hematoma size; not significantly different
- OR 0.11 (95% CI −0.67 to 0.89); P = 0.78
- Non-guideline adherent for puncture/removal · hematoma size; not significantly different
- OR 0.13 (95% CI −0.92 to 1.18); P = 0.81
- Non-guideline adherence · higher chance of persistent neurological deficit
- 3.42 (95% CI 1.71–6.86); P < 0.001
Original publication
Influence of antithrombotic medication on size and neurological outcome of spinal epidural hematoma after neuraxial anesthesia: a systematic review. Reg Anesth Pain Med. Published 21 December 2023. doi:10.
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