Thai venous stroke prognostic score: TV-SPSS.
OBJECTIVE
Prognosis of cerebral venous sinus thrombosis (CVST) has never been studied in Thailand. A simple prognostic score to predict poor prognosis of CVST has also never been reported. The authors are aiming to establish a simple and reliable prognostic score for this condition.


METHODS
The medical records of CVST patients from eight neurological training centers in Thailand who received between April 1993 and September 2005 were reviewed as part of this retrospective study. Clinical features included headache, seizure, stroke risk factors, Glasgow coma scale (GCS), blood pressure on arrival, papilledema, hemiparesis, meningeal irritation sign, location of occluded venous sinuses, hemorrhagic infarction, cerebrospinal fluid opening pressure, treatment options, length of stay, and other complications were analyzed to determine the outcome using modified Rankin scale (mRS). Poor prognosis (defined as mRS of 3-6) was determined on the discharge date.


RESULTS
One hundred ninety four patients' records, 127 females (65.5%) and mean age of 36.6 +/- 14.4 years, were analyzed Fifty-one patients (26.3%) were in the poor outcome group (mRS 3-6). Overall mortality was 8.4%. Univariate analysis and then multivariate analysis using SPSS version 11.5 revealed only four statistically significant predictors influencing outcome of CVST They were underlying malignancy, low GCS, presence of hemorrhagic infarction (for poor outcome), and involvement of lateral sinus (for good outcome). Thai venous stroke prognostic score (TV-SPSS) was derived from these four factors using a multiple logistic model.


CONCLUSIONS
A simple and pragmatic prognostic score for CVST outcome has been developed with high sensitivity (93%), yet low specificity (33%). The next study should focus on the validation of this score in other prospective populations.
Poungvarin
Niphon
N
Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. niphonp.thailand@gmail.com
Prayoonwiwat
Naraporn
N
Ratanakorn
Disya
D
Towanabut
Somchai
S
Tantirittisak
Tassanee
T
Suwanwela
Nijasri
N
Phanthumchinda
Kamman
K
Tiamkoa
Somsak
S
Chankrachang
Siwaporn
S
Nidhinandana
Samart
S
Laptikultham
Somsak
S
Limsoontarakul
Sansern
S
Udomphanthuruk
Suthipol
S
D000328:Adult; D002550:Cerebral Veins / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D018709:Statistics, Nonparametric; D013785:Thailand; D016896:Treatment Outcome; D014680:Veins