Mortality After Cerebral Venous Thrombosis

Abstract

Objectives: Cerebral venous thrombosis (CVT) has historically had a poor prognosis, but advances in diagnosis and treatment may have improved outcomes. This study evaluated mortality rates, causes of death, and predictors of early and late mortality in CVT using international data.

Methods: In this multicenter cohort study, we analyzed data from adults with CVT enrolled between 1995 and 2021. Mortality within 30 days (early) and between 31 and 365 days (late) was assessed. Cox regression identified predictors of death.

Results: Among 1,525 patients (median age 40 years [interquartile range 29-53]; 70% female), early mortality was 3.4% and one-year mortality was 5.6%. The leading cause of early death was intracerebral hemorrhage (ICH) or cerebral herniation (48.1%), followed by cancer (21.2%). Late deaths were mainly due to cancer (38.2%), ICH or herniation (23.5%), infection (17.6%), and unknown causes of death (17.6%). Predictors of early death included coma, cancer, age older than 55, ICH or herniation, and nonparenchymal hemorrhage. Cancer, age older than 55, and absence of female-specific risk factors predicted late death.

Discussion: In this large international cohort, early mortality in CVT was low and aligned with findings from previous studies. Cancer was the primary cause of late mortality, highlighting its significant role in long-term outcomes.