Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct 22:9:882.
doi: 10.3389/fneur.2018.00882. eCollection 2018.

A Practical Score for Prediction of Outcome After Cerebral Venous Thrombosis

Miguel A Barboza  1   2 , Erwin Chiquete  3 , Antonio Arauz  1 , Marlon Merlos-Benitez  1 , Alejandro Quiroz-Compeán  1 , Fernando Barinagarrementería  4 , Carlos Cantú-Brito  3
Affiliations

A Practical Score for Prediction of Outcome After Cerebral Venous Thrombosis

Miguel A Barboza et al. Front Neurol. .

Abstract

Background: Most patients with cerebral venous thrombosis (CVT) have independent survival in the short term. However, identification of high-risk individuals with an unfavorable outcome is a challenging task. We aimed to develop a CVT grading scale (CVT-GS) to aid in the short-term clinical decision-making. Methods: We included 467 consecutive patients with CVT who were hospitalized from 1981 to 2015 in two third-level referral hospitals. Factors associated with 30-day mortality were selected with bivariate analyses to integrate a Cox proportional-hazards model to determine components of the final scoring. After the scale was configured, the prognostic performance was tested for prediction of short-term death or moderately impaired to death [modified Rankin scale (mRS) > 2]. CVT-GS was categorized as mild, moderate or severe for the prediction of 30-day fatality rate and a probability of mRS > 2. Results: The 30-day case fatality rate was 9.0%. The CVT-GS (0-13 points; more points predicting poorer outcomes) was composed of parenchymal lesion size > 6 cm (3 points), bilateral Babinski signs (3 points), male sex (2 points), parenchymal hemorrhage (2 points), and level of consciousness (coma: 3 points, stupor: 2, somnolence: 1, and alert: 0). CVT was categorized as mild (0-2 points, 0.4% fatality rate), moderate (3-7 points, 9.9% fatality rate), or severe (8-13 points, 61.4% fatality rate). The CVT-GS had an accuracy of 91.6% for the prediction of 30-day mortality and 85.3% for mRS > 2. Conclusions: CVT-GS is a practical clinical tool for prediction of outcome after CVT. This score may aid in clinical decision-making and could serve to stratify patients enrolled in clinical trials.

Keywords: cerebral venous thrombosis; mortality; outcome; scale; stroke.

PubMed Disclaimer

Figures

Figure 1
Figure 1
mRS at 30 days after CVT according to CVT-GS severity category (A). Thirty-day case fatality rate and mRS > 2 according to the CVT-GS severity category (B).
Figure 2
Figure 2
Actuarial analyses with the Kaplan-Meier method for the survival probability (A) and the probability of attaining a mRS > 2 (B) at 30 days after CVT, according to the CVT-GS categories.
Figure 3
Figure 3
ROC curves for CVT-GS and ISCVT-RS accuracy analysis for the prediction of death (A) and mRS > 2 (B) at 30 days after CVT.
Figure 4
Figure 4
Positive (blue lines) and negative (red lines) post-test probability of mRS > 2 at 30 days according to different CVT-GS cut-off (A-F).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Saposnik G, Barinagarrementeria F, Brown RD, Jr, Bushnell CD, Cucchiara B, Cushman M, et al. American heart association stroke council and the council on epidemiology and prevention. diagnosis and management of cerebral venous thrombosis: a statement for health care professionals from the American Heart Association/American Stroke Association. Stroke (2011) 42:1158–92. 10.1161/STR.0b013e31820a8364 - DOI - PubMed
    1. Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. (2007) 6:162–70. 10.1016/S1474-4422(07)70029-7 - DOI - PubMed
    1. Ferro JM, Bousser MG, Canhão JM, Coutinho JM, Crassard I, Dentali F, et al. . European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology. Eur J Neurol. (2017) 24:1203–13. 10.1111/ene.13381 - DOI - PubMed
    1. Ruiz-Sandoval JL, Chiquete E, Bañuelos-Becerra LJ, Torres-Anguiano C, González-Padilla C, Arauz A, et al. . Cerebral venous thrombosis in a Mexican multicenter registry of acute cerebrovascular disease: the RENAMEVASC study. J Stroke Cerebrovas Dis. (2012) 21:395–400. 10.1016/j.jstrokecerebrovasdis.2011.01.001 - DOI - PubMed
    1. Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F; ISCVT Investigators. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke (2004) 35:664–70. 10.1161/01.STR.0000117571.76197.26 - DOI - PubMed

LinkOut - more resources