JOS: Prediction of outcomes of cerebral vein thrombosis – IN-REvASC score

Cerebral venous thrombosis (CVT) is a rare cause of stroke, with an estimated incidence of approximately 1.
5 cases per 100,000 person-years
.
Here, scholars from the United States identified risk factors and derived and validated prognostic scores
for neurological ill and death for cerebral venous thrombosis (CVT).

The researchers conducted an international multicenter retrospective study of patients with continuous CVT from January 2015 to December 2020
.
Demographic, clinical and radiological features
were collected.
Univariate and multivariate logistic regression was performed to identify risk factors for adverse outcomes, i.
e.
, mRS 3-6
.

Results A total of 1025 patients were analysed, with a median follow-up of 375 days (interquartile range [IQR], 180 to 747).

The median age was 44 years (IQR, 32 to 58), and 62.
7% were female
.

Multivariate analysis showed that the following factors were associated with adverse outcomes at 90 days follow-up: active cancer (OR = 11.
20; 95% confidence interval [CI], 4.
62 to 27.
14; P< 0.
001), age (OR = 1.
02 (per year); 95% CI, 1.
00-1.
04; P=0.
039), black ethnicity (OR=2.
17; 95% CI, 1.
10 to 4.
27; P=0.
025), encephalopathy or coma at onset (OR=2.
71; 95% CI, 1.
39-5.
30; P=0.
004), decreased hemoglobin (OR=1.
16/g/dL; 95%CI，1.
03-1
。 31; P=0.
014), NIHSS was higher at onset (OR=1.
07 (per minute); 95% CI, 1.
02 to 1.
11; P = 0.
002), and drug use (OR=2.
34; 95% CI, 1.
16-4.
71; P=0.
017).

In predicting adverse outcomes at 90 days follow-up, IN-REvASC scores were superior to ISCVT-RS (area under 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）
。

In summary, seven factors were associated
with adverse neurological outcomes following CVT.
Compared with ISCVT-RS, INREvASC scores improve the accuracy of
prognosis.
Identifying patients at highest risk of poor prognosis in CVT can aid clinical decision-making and target treatment for patients in future clinical trials
.

References:

Outcome Prediction in Cerebral Venous Thrombosis: The IN-REvASC Score.
https://doi.
org/10.
5853/jos.
2022.
01606