美国恶性肿瘤患者脑静脉血栓形成的住院预后
Inpatient Outcomes of Cerebral Venous Thrombosis in Patients With Malignancy Throughout the United States
影响因子:8.60000
分区:医学1区 Top / 临床神经病学2区 外周血管病2区
发表日期:2024 Sep
作者:
Sima Vazqez, Ankita Das, Eris Spirollari, Paige Brabant, Bridget Nolan, Kevin Clare, Jose F Dominguez, Neha Dangayach, Krishna Amuluru, Shadi Yaghi, Ji Chong, Chaitanya Medicherla, Halla Nuoaman, Neisha Patel, Stephan A Mayer, Chirag D Gandhi, Fawaz Al-Mufti
摘要
脑静脉血栓形成（CVT）与高度的发病率和死亡率有关。我们的目标是阐明癌症和CVT患者的特征，治疗和结果（CA-CVT）。对2016-2019国家住院样本（NIS）数据库进行了查询，以查询CVT主要诊断的患者。然后确定当前有效诊断恶性肿瘤（CA-CVT）的患者。比较了CA-CVT和CVT患者之间的人口统计学和合并症。亚组分析探索了造血癌和非山摩托癌患者。探索了中风的严重程度和治疗。所研究的住院结果是出院处置，住院时间和死亡率。2016年和2019年之间，有6,140名患者的主要诊断法为CVT，370名（6.0％）患者患有共存恶性肿瘤。最常见的恶性肿瘤是造血（n = 195，52.7％），其次是中枢神经系统（n = 40，10.8％），呼吸道（n = 40，10.8％）和乳房（n = 40，10.8％）。这些患者倾向于比非CA-CVT年龄大，并且更可能患有合并症。 CA-CVT患者的严重程度得分较高，对脑静脉和硬脑膜窦性血栓形成风险评分（ISCVT-RS）的国际研究和并发症的增加。在倾向评分匹配的队列中，住院结果没有差异。在有CVT的6％的患者中发生了临时性，在尚未鉴定出明显的高凝乳症原因的情况下，应将其视为潜在的合并症。恶性肿瘤与较高的死亡率有关。但是，在调整了CVT的严重程度后，与癌症相关的CVT的住院患者的结局与没有癌症的患者相当，这表明与恶性肿瘤有关的死亡率增加可能是由于CVT条件更严重。
Abstract
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).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.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.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.