International Journal of General Medicine (Sep 2023)
Prediction Score for Clinical Outcome of Chinese Patients with Cerebral Venous Thrombosis
Abstract
Min Li,1,2,* Binlong Zhang,3,* Jiangbo Xie,4 Ran Meng,1,2 Xunming Ji2,5 1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China; 3Department of Acupuncture, Moxibustion, and Neurology, Guang’anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 4Department of Neurology, Weifang Traditional Chinese Hospital, Weifang, Shandong, People’s Republic of China; 5Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ran Meng, Department of Neurology, Xuanwu Hospital, Capital Medical University, 45 Changchun Road, Xicheng District, Beijing, 100053, People’s Republic of China, Tel +86-13693080599, Email [email protected] Xunming Ji, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Road, Xicheng District, Beijing, 100053, People’s Republic of China, Tel +86-13911077166, Email [email protected]: Although numerous prognostic markers for cerebral venous thrombosis (CVT) have been reported, inconsistencies exist in their predictive values, leading to contradictory forecasts. This study was designed to develop a comprehensive clinical outcome prediction score for Chinese patients with CVT, integrating key prognostic markers to furnish an overall prognosis.Methods: Participants were selected from the CCC cohort, a multicenter study encompassing 26 tertiary hospitals across mainland China. Between January 2021 and May 2022, 170 patients with CVT were prospectively recruited. Potential prognostic markers were extracted from the CCC database and subsequently analyzed.Results: Age, diastolic blood pressure (DBP), neutrophil-to-lymphocyte ratio (NLR), and neuron-specific enolase (NSE) emerged as significant prognostic markers for CVT after a multivariate logistic analysis. Specific cut-off values were identified: Age > 27.5 years, DBP > 79.5 mmHg, NLR > 6.6, and NSE > 16.5 ng/mL. The points assigned were: one each for age and NSE level, two for DBP, and three for NLR, based on the adjusted odds ratio. A positive correlation was found between the baseline CVT outcome score and the mRS at six months’ follow-up. A CVT outcome score of 3.5 served as an effective cut-off value for predicting CVT clinical outcomes. Further analysis revealed that patients with CVT outcome scores > 3 exhibited significantly higher mRS scores than those with scores ≤ 3.Conclusion: This study led to the development of the CVT outcome score, consisting of age, DBP, NLR, and NSE level, specifically for Chinese patients with CVT. The baseline CVT outcome score positively correlated with the mRS score at the six-month follow-up. A CVT outcome score of > 3 serves as a reliable indicator to identify patients at a higher risk of unfavorable clinical outcomes. These patients may benefit from additional care and early interventions to avert potential deterioration.Keywords: clinical outcome, prognosis, cerebral venous thrombosis, prediction score, validation