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Characteristics and Outcomes of Children with Cerebral Sinus Venous Thrombosis

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An Invited Commentary to this article was published on 12 July 2023

Abstract

Background

Cerebral sinus venous thrombosis (CSVT) is an uncommon condition in children with potentially serious outcomes. Large epidemiological studies in children with CSVT are few. The objective of this study is to evaluate the epidemiology and in-hospital outcomes of hospitalized children with CSVT in the United States.

Methods

We performed a retrospective cross-sectional analysis of the Healthcare Cost and Utilization Project Kids’ Inpatient Database for the combined years 2016 and 2019. The database was queried using the diagnoses for intracranial and intraspinal phlebitis and thrombophlebitis, nonpyogenic thrombosis of the intracranial venous system, and cerebral infarction due to cerebral venous thrombosis. Sample weighting was employed to produce national estimates.

Results

Of 12,165,621 discharges, 3202 had CSVT (in-hospital prevalence 26.3 per 100,000 discharges). Male patients accounted for 57% of CSVT discharges. The median age was 8 years (interquartile range 1–16), with a U-shaped distribution with peaks in patients younger than 4 years and patients aged between 18 and 20 years. A total of 19.3% of children with CSVT had either hemorrhagic or ischemic stroke. Patients with stroke were more likely to require mechanical ventilation (odds ratio [OR] 2.7; 95% confidence interval [CI] 2.1–3.3; p < 0.001) and have higher mortality (OR 2.3; 95% CI 1.6–3.4; p < 0.001). Mechanical ventilation was necessary for 25.2% of patients with CSVT, of whom the majority were neonates and young children. The need for mechanical ventilation was associated with increased mortality (OR 16.6; 95% CI 9.9–27.9; p < 0.001). The overall mortality rate for CSVT was 4.1%, and 16.5% of patients with CSVT were discharged with home health care or to a skilled nursing facility.

Conclusions

CSVT, which has a U-shaped age distribution, is an uncommon condition in children. Stroke is common in children with CSVT, and it is associated with an increased need for mechanical ventilation and increased mortality. The need for mechanical ventilation is more common in infants, and it is associated with increased mortality across all age groups.

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Authors and Affiliations

  1. Marshall University Joan C Edwards School of Medicine, 1600 Medical Center Drive, Huntington, WV, 25705, USA

    Juan Sebastian Proaño

  2. Department of Pediatric Critical Care, Nicklaus Children’s Hospital, Miami, USA

    Paul A. Martinez, Prithvi Sendi & Balagangadhar R. Totapally

  3. Herbert Wertheim College of Medicine, Florida International University, Miami, USA

    Paul A. Martinez, Prithvi Sendi & Balagangadhar R. Totapally

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  1. Juan Sebastian Proaño
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  4. Balagangadhar R. Totapally
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Contributions

Conception or design of the work: JSP and BRT. Data collection: JSP and PS. Data analysis and interpretation: JSP, PAM, and BRT. Drafting the article: JSP. Critical revision of the article: PAM and BRT. Final approval of the version to be published: JSP, PS, PAM, and BRT.

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Correspondence to Juan Sebastian Proaño.

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Abstract was presented at the Society of Critical Care Medicine Annual Congress in 2021.

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Proaño, J.S., Martinez, P.A., Sendi, P. et al. Characteristics and Outcomes of Children with Cerebral Sinus Venous Thrombosis. Neurocrit Care 39, 331–338 (2023). https://doi.org/10.1007/s12028-023-01765-7

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  • DOI: https://doi.org/10.1007/s12028-023-01765-7

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