Clinical characteristics and risk factors for in-hospital death due to cerebral venous sinus thrombosis in three medical centers over a 10-year period

Objectives: We retrospectively described and analyzed clinical risk factors for in-hospital death due to cerebral venous thrombosis (CVT). Methods: A total of 172 CVT patients were seen over a 10-year period at three medical centers in China. Demographic and clinical characteristics, neuroimaging, treatment, and outcome data were collected and analyzed. Results: The 28-day in-hospital mortality rate was 4.1%. All seven deceased patients died of transtentorial herniation and were more likely to exhibit coma (42.86% vs. 3.64%, P = 0.003), intracranial hemorrhage (ICH; 85.71% vs. 36.36%, P = 0.013), straight sinus thrombosis (71.43% vs. 26.06%, P = 0.019), and thrombosis of the deep cerebral venous system (DVS; 28.57% vs. 3.64%, P = 0.036) than surviving patients. Multivariate analysis identified coma (odds ratio [OR], 11.17; 95% confidence interval [CI], 1.85-67.46, P = 0.009), ICH (OR, 20.47; 95% CI, 1.11-376.95, P = 0.042), and DVS thrombosis (OR, 36.16; 95% CI, 2.66-491.95, P = 0.007) as independent acute-phase mortality predictors. Thirty-six patients received endovascular treatment. The Glasgow Coma Scale score increased postoperatively compared with preoperatively (P = 0.017). Conclusions: The main cause of 28-day in-hospital CVT-associated death was a transtentorial hernia, and patients with risk factors such as ICH, coma, and DVS thrombosis were more likely to die. Endovascular treatment may be a safe and effective treat-ment for severe CVT when conventional management is inadequate.