title: Predictors of hospital outcome in patients with cerebral venous thrombosis.
abstract: BACKGROUND
  The studies regarding clinical presentations, risk factors, and outcomes of cerebral venous thrombosis (CVT) in Thai people are scarce. This study aims to identify predictors of hospital outcomes among the Thai patients with CVT.
  
  
  METHODS
  Patients diagnosed with CVT in Songklanagarind Hospital from January 2002 to December 2013 were identified from computerized medical record system. Demographic data, clinical presentations, associated factors, method of neuroimaging studies and results, treatment, and hospital outcomes were presented by descriptive statistics. Predictors of hospital outcomes were analyzed by both univariate and multivariate logistic regression analysis.
  
  
  RESULTS
  There were 90 patients with a diagnosis of CVT. The mean age (± standard deviation) was 41.22 (± 17.13) years (range, 15-80). The common clinical presentations were focal neurologic deficits (36.7%), seizure (33.3%), and cavernous sinus syndrome (32.2%). The common associated conditions were intracranial or paracranial infections (30.0%) and cancer (11.1%). Intracranial hemorrhage was found in 33 patients (36.7%). Forty-seven patients (52.2%) were dependent or death (Modified Rankin Scale [mRS], 3-6) on hospital discharge. Eleven patients (12.2%) were dead, of which 7 cases (7.78%) were CVT-related deaths. The independent predictors of dependency or death (mRS, 3-6) identified by multivariate logistic regression analysis were focal neurologic (odds ratio [OR], 14.26; 95% confidence interval [CI], 2.28-89.04; P = .001), mRS score of 3-5 on admission (OR, 35.26; 95% CI, 7.30-170.42; P = .000), and seizure (OR, .19; 95% CI, .03-1.02; P = .037).
  
  
  CONCLUSIONS
  Focal neurologic deficit and severely disabled patients (mRS, 3-5) on admission were independent predictors of dependency or death in CVT patients. However, seizure predicted the lower incidence of dependency or death. The characteristic findings of CVT among Thai patients were the higher incidence of cavernous sinus syndrome and rhinosinal or intracranial infection.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. Electronic address: patosk120@gmail.com.
authors.forename: Pat
authors.initials: P
authors.lastname: Korathanakhun
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Pornchai
authors.initials: P
authors.lastname: Sathirapanya
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Sarayut Lucien
authors.initials: SL
authors.lastname: Geater
authors.affiliation: Department of Surgical Nursing, Faculty of Nursing Science, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Wongchan
authors.initials: W
authors.lastname: Petpichetchian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology; D007297:Inpatients / Q000706:statistics & numerical data; D020300:Intracranial Hemorrhages / Q000453:epidemiology; D020767:Intracranial Thrombosis / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology / Q000209:etiology; D020246:Venous Thrombosis / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D055815:Young Adult
keywords: Cerebral venous thrombosis; Thai people; cavernous sinus syndrome; hospital outcome; predictors; rhinosinal infection