title: Risk of Pulmonary Embolism After Cerebral Venous Thrombosis.
abstract: Cerebral vein thrombosis (CVT) is a type of venous thromboembolism. Whether the risk of pulmonary embolism (PE) after CVT is similar to the risk after deep venous thrombosis (DVT) is unknown.
  
  
  
  We performed a retrospective cohort study using administrative data from all emergency department visits and hospitalizations in California, New York, and Florida from 2005 to 2013. We identified patients with CVT or DVT and the outcome of PE using previously validatedInternational Classification of Diseases, Ninth Revision, Clinical Modificationcodes. Kaplan-Meier survival statistics and Cox proportional hazards models were used to compare the risk of PE after CVT versus PE after DVT.
  
  
  
  We identified 4754 patients with CVT and 241 276 with DVT. During a mean follow-up of 3.4 (±2.4) years, 138 patients with CVT and 23 063 with DVT developed PE. CVT patients were younger, more often female, and had fewer risk factors for thromboembolism than patients with DVT. During the index hospitalization, the rate of PE was 1.4% (95% confidence interval [CI], 1.1%-1.8%) in patients with CVT and 6.6% (95% CI, 6.5%-6.7%) in patients with DVT. By 5 years, the cumulative rate of PE after CVT was 3.4% (95% CI, 2.9%-4.0%) compared with 10.9% (95% CI, 10.8%-11.0%;P<0.001) after DVT. CVT was associated with a lower adjusted hazard of PE than DVT (hazard ratio, 0.26; 95% CI, 0.22-0.31).
  
  
  
  The risk of PE after CVT was significantly lower than the risk after DVT. Among patients with CVT, the greatest risk for PE was during the index hospitalization.
authors.affiliation: From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).
authors.forename: Ava L
authors.initials: AL
authors.lastname: Liberman
authors.affiliation: From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.). alm9097@med.cornell.edu.
authors.forename: Alexander E
authors.initials: AE
authors.lastname: Merkler
authors.affiliation: From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).
authors.forename: Gino
authors.initials: G
authors.lastname: Gialdini
authors.affiliation: From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).
authors.forename: Steven R
authors.initials: SR
authors.lastname: Messé
authors.affiliation: From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).
authors.forename: Michael P
authors.initials: MP
authors.lastname: Lerario
authors.affiliation: From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).
authors.forename: Santosh B
authors.initials: SB
authors.lastname: Murthy
authors.affiliation: From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).
authors.forename: Hooman
authors.initials: H
authors.lastname: Kamel
authors.affiliation: From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).
authors.forename: Babak B
authors.initials: BB
authors.lastname: Navi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D005260:Female; D005431:Florida / Q000453:epidemiology; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D020767:Intracranial Thrombosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011655:Pulmonary Embolism / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D054556:Venous Thromboembolism / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000453:epidemiology*
keywords: cerebral venous thrombosis; deep vein thrombosis; pulmonary embolism; thrombosis; venous thromboembolism