Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark.
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Blood Adv. 2023 May 23;7(10):2070-2081. doi: 10.1182/bloodadvances.2022008622.
Cerebral venous thrombosis (CVT) predominantly affects young to middle-aged women. Scarce data exist regarding the long-term prognosis. We examined the clinical course of patients with CVT overall and according to their age and sex. Using Danish registries, we identified all patients with a first-time primary inpatient diagnosis of CVT from 1996-2018 (N = 653; median age, 41 years; 67% women) and individuals from the general population matched for age, sex, and calendar year (N = 65 300). Patients with CVT were at an increased risk of venous thromboembolism (VTE) at other sites, ischemic stroke, major bleeding, and mortality. For both sexes, the increased risks of VTE at other sites were most prominent among younger patients (18-54 years), whereas the increased risks of ischemic stroke, major bleeding, and mortality were most prominent among older patients (≥55 years). Among young women, the 10-year risks of VTE at other sites for patients with CVT compared with members of the matched cohort were 2.2% vs 0.4% (risk difference, 1.8%; 95% confidence interval [CI], 0.0-3.6). Among older women, compared with members of the matched cohort, the 10-year risks were 12.8% vs 3.1% (risk difference, 9.7%; 95% CI, 1.6-17.9) for ischemic stroke, 11.1% vs 4.6% (risk difference, 6.5%; 95% CI, -1.0 to 14.1) for major bleeding, and 43.1% vs 26.7% (risk difference, 16.4%; 95% CI, 3.7-29.1) for all-cause mortality. The risk of myocardial infarction was not elevated. Clinicians should be aware of the importance of age and sex heterogeneity in the prognosis of CVT.
脑静脉血栓形成（CVT）主要影响中青年女性。关于其长期预后的数据很少。我们检查了 CVT 患者的总体临床病程，以及根据他们的年龄和性别进行的分析。我们使用丹麦的登记处，从 1996 年至 2018 年确定了所有初次住院诊断为 CVT 的患者（n=653；中位年龄为 41 岁；67%为女性），并根据年龄、性别和日历年份匹配了普通人群中的个体（n=65300）。CVT 患者发生其他部位静脉血栓栓塞（VTE）、缺血性中风、大出血和死亡的风险增加。对于所有性别，年轻患者（18-54 岁）的其他部位 VTE 风险增加最为明显，而老年患者（≥55 岁）的缺血性中风、大出血和死亡风险增加最为明显。在年轻女性中，与匹配队列的成员相比，CVT 患者在 10 年内发生其他部位 VTE 的风险为 2.2%比 0.4%（风险差异，1.8%；95%置信区间 [CI]，0.0-3.6）。在老年女性中，与匹配队列的成员相比，10 年内的风险为缺血性中风 12.8%比 3.1%（风险差异，9.7%；95%CI，1.6-17.9）、大出血 11.1%比 4.6%（风险差异，6.5%；95%CI，-1.0 至 14.1）和全因死亡率 43.1%比 26.7%（风险差异，16.4%；95%CI，3.7-29.1）。心肌梗死的风险没有增加。临床医生应意识到 CVT 预后存在年龄和性别异质性的重要性。
