Li Min, Zhang Binlong, Xie Jiangbo, Meng Ran, Ji Xunming
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.
Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People's Republic of China.
Int J Gen Med. 2023 Sep 11;16:4099-4107. doi: 10.2147/IJGM.S426238. eCollection 2023.
Although numerous prognostic markers for cerebral venous thrombosis (CVT) have been reported, inconsistencies exist in their predictive values, leading to contradictory forecasts. This study was designed to develop a comprehensive clinical outcome prediction score for Chinese patients with CVT, integrating key prognostic markers to furnish an overall prognosis.
Participants were selected from the CCC cohort, a multicenter study encompassing 26 tertiary hospitals across mainland China. Between January 2021 and May 2022, 170 patients with CVT were prospectively recruited. Potential prognostic markers were extracted from the CCC database and subsequently analyzed.
Age, diastolic blood pressure (DBP), neutrophil-to-lymphocyte ratio (NLR), and neuron-specific enolase (NSE) emerged as significant prognostic markers for CVT after a multivariate logistic analysis. Specific cut-off values were identified: Age > 27.5 years, DBP > 79.5 mmHg, NLR > 6.6, and NSE >16.5 ng/mL. The points assigned were: one each for age and NSE level, two for DBP, and three for NLR, based on the adjusted odds ratio. A positive correlation was found between the baseline CVT outcome score and the mRS at six months' follow-up. A CVT outcome score of 3.5 served as an effective cut-off value for predicting CVT clinical outcomes. Further analysis revealed that patients with CVT outcome scores > 3 exhibited significantly higher mRS scores than those with scores ≤ 3.
This study led to the development of the CVT outcome score, consisting of age, DBP, NLR, and NSE level, specifically for Chinese patients with CVT. The baseline CVT outcome score positively correlated with the mRS score at the six-month follow-up. A CVT outcome score of > 3 serves as a reliable indicator to identify patients at a higher risk of unfavorable clinical outcomes. These patients may benefit from additional care and early interventions to avert potential deterioration.
尽管已报道了众多脑静脉血栓形成（CVT）的预后标志物，但其预测价值存在不一致性，导致预测相互矛盾。本研究旨在为中国CVT患者开发一种综合临床结局预测评分系统，整合关键预后标志物以提供总体预后情况。
研究对象选自CCC队列，这是一项涵盖中国大陆26家三级医院的多中心研究。在2021年1月至2022年5月期间，前瞻性招募了170例CVT患者。从CCC数据库中提取潜在的预后标志物并随后进行分析。
经过多因素逻辑回归分析，年龄、舒张压（DBP）、中性粒细胞与淋巴细胞比值（NLR）和神经元特异性烯醇化酶（NSE）成为CVT的显著预后标志物。确定了特定的临界值：年龄>27.5岁、DBP>79.5 mmHg、NLR>6.6和NSE>16.5 ng/mL。根据调整后的比值比，赋予的分值为：年龄和NSE水平各1分，DBP为2分，NLR为3分。在6个月随访时，基线CVT结局评分与改良Rankin量表（mRS）之间存在正相关。CVT结局评分为3.5作为预测CVT临床结局的有效临界值。进一步分析显示，CVT结局评分>3的患者mRS评分显著高于评分≤3的患者。
本研究开发了CVT结局评分系统，该系统由年龄、DBP、NLR和NSE水平组成，专门针对中国CVT患者。基线CVT结局评分与6个月随访时的mRS评分呈正相关。CVT结局评分>3可作为识别临床结局不良风险较高患者的可靠指标。这些患者可能受益于额外的护理和早期干预，以避免潜在的病情恶化。
