Inpatient Outcomes of Cerebral Venous Thrombosis in Patients With Malignancy Throughout the United States
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Background and Purpose Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT). Methods The 2016–2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality. Results Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes. Conclusion Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.
Abstract
Background and Purpose Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT). Methods The 2016–2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality. Results Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes. Conclusion Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.
참고문헌 (28)
- Labagnara KF, "Analyzing the effects of demographic differences on patient outcomes following non-pyogenic intracranial venous thrombosis", Cureus, 13, pp.e19753~ (2021)
- Cohen O, "Cerebral venous thrombosis", Minerva Med, 112, pp.755~766 (2021)
- Stam J, "Thrombosis of the cerebral veins and sinuses", N Engl J Med, 352, pp.1791~1798 (2005)
- Otite FO, "Trends in incidence and epidemiologic characteristics of cerebral venous thrombosis in the United States", Neurology, 95, pp.e2200~e2213 (2020)
- Dmytriw AA, "Cerebral venous thrombosis : state of the art diagnosis and management", Neuroradiology, 60, pp.669~685 (2018)
- de Freitas GR, "Risk factors of cerebral vein and sinus thrombosis", Front Neurol Neurosci, 23, pp.23~54 (2008)
- Ameri A, "Cerebral venous thrombosis", Neurol Clin, 10, pp.87~111 (1992)
- Borhani Haghighi A, "Mortality of cerebral venous-sinus thrombosis in a large national sample", Stroke, 43, pp.262~264 (2012)
- Silvis SM, "Cancer and risk of cerebral venous thrombosis : a case-control study", J Thromb Haemost, 16, pp.90~95 (2018)
- Streiff MB, "Thrombosis in the setting of cancer", Hematology Am Soc Hematol Educ Program, 2016, pp.196~205 (2016)
- "HCUP National Inpatient Sample (NIS) database"[URL]
- Ferro JM, "Risk score to predict the outcome of patients with cerebral vein and dural sinus thrombosis", Cerebrovasc Dis, 28, pp.39~44 (2009)
- Al Hashmi K, "Characteristics and outcomes of patients with cerebral venous sinus thrombosis", Oman Med J, 34, pp.434~437 (2019)
- Xian Z, "A clinical research on the potential pathogenesis of somatic cancer related cerebral venous sinus thrombosis", Medicine(Baltimore), 98, pp.e15134~ (2019)
- Al-Mufti F, "Cerebral venous thrombosis in COVID-19 : a New York metropolitan cohort study", AJNR Am J Neuroradiol, 42, pp.1196~1200 (2021)
- Skajaa N, "Risk and prognosis of cancer in patients with cerebral venous thrombosis compared with the Danish general population", Stroke, 54, pp.2576~2582 (2023)
- Dardiotis E, "Cancer-associated stroke : pathophysiology, detection and management(review)", Int J Oncol, 54, pp.779~796 (2019)
- Mulder FI, "Venous thromboembolism in cancer patients : a population-based cohort study", Blood, 137, pp.1959~1969 (2021)
- Ferro JM, "Cerebral venous thrombosis", Presse Med, 45(12 Pt 2), pp.e429~e450 (2016)
- Piazza G, "Cerebral venous thrombosis", Circulation, 125, pp.1704~1709 (2012)
- Battaglia CC, "Hospital-acquired infections in critically ill patients with cancer", J Intensive Care Med, 34, pp.523~536 (2019)
- Branchford BR, "The role of inflammation in venous thromboembolism", Front Pediatr, 6, pp.142~ (2018)
- Haukland EC, "Adverse events in hospitalised cancer patients : a comparison to a general hospital population", Acta Oncol, 56, pp.1218~1223 (2017)
- Miriovsky BJ, "Heparin-induced thrombocytopenia in cancer", J Natl Compr Canc Netw, 9, pp.781~787 (2011)
- Gonzales M, "Refractory heparin-induced thrombocytopenia with cerebral venous sinus thrombosis treated with IVIg, steroids, and a combination of anticoagulants : a case report", J Investig Med High Impact Case Rep, 7, pp.2324709619832324~ (2019)
- Fesler MJ, "Heparin-induced thrombocytopenia and cerebral venous sinus thrombosis : case report and literature review", Neurocrit Care, 15, pp.161~165 (2011)
- Shapiro SD, "Investigating outcomes post-endovascular thrombectomy in acute stroke patients with cancer", Neurology, 99, pp.e2583~e2592 (2022)
- Zhou LW, "Prognosis after cerebral venous thrombosis : mortality during initial admission and at 30 days and one year after discharge in a large Canadian population-based cohort", Thromb Res, 233, pp.145~152 (2024)