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논문 기본 정보

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학술저널
저자정보
Piers Klein (Department of Neurology Boston Medical Center Boston University School of Medicine Boston MA USA) Liqi Shu (Department of Neurology Brown University Providence RI USA) Thanh N. Nguyen (Boston Medical Center Boston University School of Medicine Boston MA USA) James E. Siegler (Department of Neurology Cooper Neurological Institute Cooper University Hospital Camden NJ USA) Setareh Salehi Omran (Department of Neurology University of Colorado School of Medicine Aurora CO USA) Alexis N. Simpkins (Department of Neurology University of Florida Gainesville FL USA) Mirjam Heldner (Department of Neurology Inselspital University Hospital Bern University of Bern Bern Switzerland) Adam de Havenon (Department of Neurology Yale University New Haven CT USA) Hugo J. Aparicio (Department of Neurology Boston Medical Center Boston University School of Medicine Boston MA USA) Mohamad Abdalkader (Department of Neurology Boston Medical Center Boston University School of Medicine Boston MA USA) Marios Psychogios (Department of Neuroradiology Clinic of Radiology and Nuclear Medicine University Hospital Basel Bas) Maria Cristina Vedovati (Department of Medicine and Surgery University of Perugia Perugia Italy) Maurizio Paciaroni (Neurology–Stroke Unit IRCCS MultiMedica Milano Italy) Rascha von Martial (Department of Neurology Inselspital University Hospital Bern University of Bern Bern Switzerland) David S. Liebeskind (Department of Neurology University of California at Los Angeles Los Angeles CA USA) Diana Aguiar de Sousa (Department of Neurosciences and Mental Health Neurology Service Hospital de Santa Maria/CHULN Unive) Jonathan M. Coutinho (Department of Neurology Amsterdam University Medical Center location AMC Amsterdam The Netherlands) Shadi Yaghi (Department of Neurology Brown University Providence RI USA)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제24권 제3호
발행연도
2022.9
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404 - 416 (13page)

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Background We identified risk factors, derived and validated a prognostic score for poor neurological outcome and death for use in cerebral venous thrombosis (CVT). Methods We performed an international multicenter retrospective study including consecutive patients with CVT from January 2015 to December 2020. Demographic, clinical, and radiographic characteristics were collected. Univariable and multivariable logistic regressions were conducted to determine risk factors for poor outcome, mRS 3-6. A prognostic score was derived and validated. Results A total of 1,025 patients were analyzed with median 375 days (interquartile range [IQR], 180 to 747) of follow-up. The median age was 44 (IQR, 32 to 58) and 62.7% were female. Multivariable analysis revealed the following factors were associated with poor outcome at 90- day follow-up: active cancer (odds ratio [OR], 11.20; 95% confidence interval [CI], 4.62 to 27.14; P<0.001), age (OR, 1.02 per year; 95% CI, 1.00 to 1.04; P=0.039), Black race (OR, 2.17; 95% CI, 1.10 to 4.27; P=0.025), encephalopathy or coma on presentation (OR, 2.71; 95% CI, 1.39 to 5.30; P=0.004), decreased hemoglobin (OR, 1.16 per g/dL; 95% CI, 1.03 to 1.31; P=0.014), higher NIHSS on presentation (OR, 1.07 per point; 95% CI, 1.02 to 1.11; P=0.002), and substance use (OR, 2.34; 95% CI, 1.16 to 4.71; P=0.017). The derived IN-REvASC score outperformed ISCVT-RS for the prediction of poor outcome at 90-day follow-up (area under the curve [AUC], 0.84 [95% CI, 0.79 to 0.87] vs. AUC, 0.71 [95% CI, 0.66 to 0.76], χ2 P<0.001) and mortality (AUC, 0.84 [95% CI, 0.78 to 0.90] vs. AUC, 0.72 [95% CI, 0.66 to 0.79], χ2 P=0.03). Conclusions Seven factors were associated with poor neurological outcome following CVT. The INREvASC score increased prognostic accuracy compared to ISCVT-RS. Determining patients at highest risk of poor outcome in CVT could help in clinical decision making and identify patients for targeted therapy in future clinical trials.
#Stroke #Sinus thrombosis #intracranial #Prognosis

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