Trends in incidence and epidemiologic characteristics of cerebral venous thrombosis in the United States

Affiliations

¹ From the Department of Neurology (F.O.O., J.G.L.), State University of New York Upstate Medical University, Syracuse; Department of Neurology (S.P.), University of Connecticut, Hartford; Department of Neurology (R.S.), Yale University, New Haven, CT; Department of Internal Medicine (P. Khandwala, D.D.), Crozier Chester Medical Center, Chester, PA; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Healthcare Transformation Initiative (N.A.), University of Texas Health Science Center at Houston; Department of Neurology (S.I.), Brigham and Women's Hospital/Harvard Medical School, Boston, MA; Department of Neurology (A.M.M., D.Y.), University of Miami Miller School of Medicine, FL; Department of Neurology (P. Khandelwal), Rutgers New Jersey Medical School, Newark; and Department of Neurology (S.C.), University of Maryland, Baltimore. otitef@upstate.edu.
² From the Department of Neurology (F.O.O., J.G.L.), State University of New York Upstate Medical University, Syracuse; Department of Neurology (S.P.), University of Connecticut, Hartford; Department of Neurology (R.S.), Yale University, New Haven, CT; Department of Internal Medicine (P. Khandwala, D.D.), Crozier Chester Medical Center, Chester, PA; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Healthcare Transformation Initiative (N.A.), University of Texas Health Science Center at Houston; Department of Neurology (S.I.), Brigham and Women's Hospital/Harvard Medical School, Boston, MA; Department of Neurology (A.M.M., D.Y.), University of Miami Miller School of Medicine, FL; Department of Neurology (P. Khandelwal), Rutgers New Jersey Medical School, Newark; and Department of Neurology (S.C.), University of Maryland, Baltimore.

PMID: 32847952
PMCID: PMC7713788
DOI: 10.1212/WNL.0000000000010598

Trends in incidence and epidemiologic characteristics of cerebral venous thrombosis in the United States

Fadar Oliver Otite et al. Neurology. 2020.

. 2020 Oct 20;95(16):e2200-e2213.

doi: 10.1212/WNL.0000000000010598. Epub 2020 Aug 26.

Affiliations

¹ From the Department of Neurology (F.O.O., J.G.L.), State University of New York Upstate Medical University, Syracuse; Department of Neurology (S.P.), University of Connecticut, Hartford; Department of Neurology (R.S.), Yale University, New Haven, CT; Department of Internal Medicine (P. Khandwala, D.D.), Crozier Chester Medical Center, Chester, PA; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Healthcare Transformation Initiative (N.A.), University of Texas Health Science Center at Houston; Department of Neurology (S.I.), Brigham and Women's Hospital/Harvard Medical School, Boston, MA; Department of Neurology (A.M.M., D.Y.), University of Miami Miller School of Medicine, FL; Department of Neurology (P. Khandelwal), Rutgers New Jersey Medical School, Newark; and Department of Neurology (S.C.), University of Maryland, Baltimore. otitef@upstate.edu.
² From the Department of Neurology (F.O.O., J.G.L.), State University of New York Upstate Medical University, Syracuse; Department of Neurology (S.P.), University of Connecticut, Hartford; Department of Neurology (R.S.), Yale University, New Haven, CT; Department of Internal Medicine (P. Khandwala, D.D.), Crozier Chester Medical Center, Chester, PA; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Healthcare Transformation Initiative (N.A.), University of Texas Health Science Center at Houston; Department of Neurology (S.I.), Brigham and Women's Hospital/Harvard Medical School, Boston, MA; Department of Neurology (A.M.M., D.Y.), University of Miami Miller School of Medicine, FL; Department of Neurology (P. Khandelwal), Rutgers New Jersey Medical School, Newark; and Department of Neurology (S.C.), University of Maryland, Baltimore.

PMID: 32847952
PMCID: PMC7713788
DOI: 10.1212/WNL.0000000000010598

Abstract

Objective: To test the hypothesis that race-, age-, and sex-specific incidence of cerebral venous thrombosis (CVT) has increased in the United States over the last decade.

Methods: In this retrospective cohort study, validated ICD codes were used to identify all new cases of CVT (n = 5,567) in the State Inpatients Databases (SIDs) of New York and Florida (2006-2016). A new CVT case was defined as first hospitalization for CVT in the SID without prior CVT hospitalization. CVT counts were combined with annual Census data to compute incidence. Joinpoint regression was used to evaluate trends in incidence over time.

Results: From 2006 to 2016, annual age- and sex-standardized incidence of CVT in cases per 1 million population ranged from 13.9 to 20.2, but incidence varied significantly by sex (women 20.3-26.9, men 6.8-16.8) and by age/sex (women 18-44 years of age 24.0-32.6, men 18-44 years of age 5.3-12.8). Incidence also differed by race (Blacks: 18.6-27.2; Whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006 to 2016, but most of this increase was driven by an increase in all age groups of men (combined annualized percentage change [APC] 9.2%, p < 0.001), women 45 to 64 years of age (APC 7.8%, p < 0.001), and women ≥65 years of age (APC 7.4%, p < 0.001). Incidence in women 18 to 44 years of age remained unchanged over time.

Conclusion: CVT incidence is disproportionately higher in Blacks compared to other races. New CVT hospitalizations increased significantly over the last decade mainly in men and older women. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or an artifactual increase from improved detection.

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Figures

**Figure 1. Joinpoint regression of trends in age-standardized incidence of CVT in New York and Florida from 2006 to 2016, according to sex**
APC = annualized percentage change; CI = confidence interval; CVT = cerebral venous thrombosis.

**Figure 2. Joinpoint regression of trends in incidence of CVT in New York and Florida from 2006 to 2016, according to sex and age groups**
In men, yearly annualized percentage change (APC) estimates for the age groups of 18 to 44 and 45 to 64 years are displayed underneath their regression lines, and the estimate for ≥65 years of age is displayed above the regression line. In women, APC estimates for those 18 to 44 and ≥65 years of age are depicted above the regression line, and that for women 45 to 64 years of age is depicted underneath the regression line.

See this image and copyright information in PMC

References

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Trends in incidence and epidemiologic characteristics of cerebral venous thrombosis in the United States

Affiliations

Trends in incidence and epidemiologic characteristics of cerebral venous thrombosis in the United States

Authors

Affiliations

Abstract

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical