Abstract Details

Title Mortality and One-Year Readmission Rates Following Hospital Discharge in a Large Canadian Cerebral Venous Thrombosis Cohort

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S35 - Cerebrovascular Disease: Meta-analyses and Outcomes Research (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Background Prognosis following cerebral venous thrombosis (CVT) is thought to be favourable, though there are a limited number of studies examining longer-term outcomes.

Objective

We examined factors associated with death and readmission at one year following hospital discharge in a consecutive cohort of Canadian patients with CVT identified through administrative data.

Design/Methods People with a new diagnosis of CVT between 2000-2017 in the Canadian province of British Columbia (pop. 5 million) were identified using ICD codes from the Canadian Institute for Health Information’s Discharge Abstract Database. Data linkages to outpatient prescriptions, vital statistics, cancer, and prenatal registries were made. We examined rates and risk factors for the composite primary outcome of death and re-hospitalization with CVT-related complications at 1 year using univariate analysis and multi-variable logistic regression.

Results

Of 554 incident CVT cases, 508(92%) survived their index admission. Within 1 year, 65/508(13%) were readmitted with CVT, other venous thromboembolism (VTE), seizure or intracranial bleeding and 49/508(9.6%) died. When examined together, older age (OR 1.03, 95%CI 1.01-1.04) but not sex, was associated with a higher rate of the primary composite outcome. After adjustment for age and sex, those with recent/active cancer (15% of cases, aOR 3.69(95% CI 2.16-6.32) and those with a history of prior VTE (6% of cases, aOR 3.21(95% CI 1.43-7.18) had a higher likelihood of death/readmission. Being discharged on anticoagulation (62% of cases, aOR 0.62(95% CI 0.39-0.99) was associated with a lower likelihood of death/readmission. There was no significant interaction suggesting differing effects of anticoagulation based on cancer status or head trauma(9% of cases) at initial admission.

Conclusions

During the first year after discharge from hospital with a diagnosis of CVT mortality was high at 9.6% and 13% of patients were readmitted due to CVT-related complications. Active/recent cancer, a history of prior VTE and older age were associated with higher risk of death/readmission.

Authors/Disclosures
Lily Zhou, MD (Vancouver General Hospital) PRESENTER	Dr. Zhou has received research support from Canadian Institute of Health Research.
	No disclosure on file
Thalia S. Field, MD (University of British Columbia)	Dr. Field has received personal compensation for serving as an employee of Springer. Dr. Field has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Canadian Medical Protective Association. The institution of Dr. Field has received research support from Bayer Canada.