J Stroke.  2024 Sep;26(3):425-433. 10.5853/jos.2023.04098.

Inpatient Outcomes of Cerebral Venous Thrombosis in Patients With Malignancy Throughout the United States

• Vazqez S
• Das A
• Spirollari E
• Brabant P
• Nolan B
• Clare K
• Dominguez JF
• Dangayach N
• Amuluru K
• Yaghi S
• Chong J
• Medicherla C
• Nuoaman H
• Patel N
• Mayer SA
• Gandhi CD
• Al-Mufti F

• KMID: 2559560
• DOI: http://doi.org/10.5853/jos.2023.04098

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.

Keyword

Malignancy; Cerebral venous thrombosis; Endovascular therapy; Hypercoagulability

Reference

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