Contemporary Incidence and Burden of Cerebral Venous Sinus Thrombosis in Children of the United States

Background: The incidence of cerebral venous thrombosis (CVT) in children of the United States is unknown, and it is uncertain how the burden of CVT hospitalizations in children changed over the last decade. Methods: We conducted a retrospective cohort study using the State Inpatient Database and Kid's inpatient database. All new CVT cases in children (0-19 years) in the New York 2006 to 2018 State Inpatient Database (n=705), and all cases of CVT in the entire US contained in the 2006 to 2019 Kid's inpatient database (weighted n=6115) were identified using validated International Classification of Diseases (ICDs) codes. Incident counts were combined with census data to compute incidence. Between-group differences in incidence were tested using 2-proportions Z-test, and Joinpoint regression was used to trend incidence over time. Results: Across the study period, 48.2% of all incident CVT cases and 44.6% of all CVT admissions nationally were in girls. Of all incident cases, 27.2% were infants and 65.8% of these infants were neonates. Average incidence across the study period was (1.1/100000/year, SE:0.04) but incidence in infants (6.4/100000/year) was at least 5 times the incidence in other age groups (1-4 years: 0.7/100000/year, 15-19 years: 1.2/100000/year). Incidence and national burden of CVT admissions was higher in girls in adolescents 15 to 19 years, but overall burden was higher in boys in other age groups. Age- and sex-standardized CVT incidence increased by 3.8% annually (95% CI, 0.2%-7.6%), while the overall burden of admissions increased by 4.9% annually (95% CI, 3.6%-6.2%). Conclusions: CVT incidence in New York and national burden of CVT increased significantly over the last decade.