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The Importance of Recanalization in Intracranial Venous Thrombosis and Predictive Factors

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Resumo:Introduction: Cerebral venous thrombosis (CVT) is a rare disease that affects mainly young people. The importance of recanalizationis controversial but it is related to residual symptoms/ signs. This study aims to calculate the incidence of CVT, to evaluatethe importance of recanalization and to define its predictive factors.Material and Methods: This is a retrospective observational study involving patients with CVT diagnosed between 2004 to 2014 in Braga Hospital. Functional assessment was based on the modified Rankin scale. Recanalization was defined as thepresence of venous flow in all vessels, including residual. A descriptive statistical analysis was conducted and used test t Student(t), Mann-Whitney U(U), chi-square(χ2) or Fisher’s exact test a binary logistic regression was used for predictive model. It wasrecognized statistical significance p < 0.05.Results: The incidence of CVT was estimated at 1.82 cases per 100 000 person-years. The recanalization was associated with the functional evaluation at 6 (Fisher’s exact test, p < 0.001, φc =0.511) and 12 months (Fisher’s exact test, p = 0.001, φc =0.480), inability to six (Fisher’s exact test, p = 0.024,φ = 0.305) and 12 months (Fisher’s exact test, p = 0.023,φ = 0.305), and the residual symptoms/signals at 3 months (χ2(1) = 23.46, p < 0.001,φ = 0.605). The obtained regression model included the following predictive variables age, arterial hypertension, dyslipidemia, altered state of consciousness and new residual symptoms/signs. This was statistically significant (χ2(5) = 37.43, p < 0.001), with a sensitivity of 90.0% and specificity of 70.8%. New residual symptoms/signs is the best predictor of no recanalization (OR = 33.33).Discussion and Conclusion: The recanalization has an important role in prognosis; it was possible to predict its occurrence basedon five variables.
Autores principais:Azevedo, Soraia
Outros Autores:Correia, Anabela
Assunto:Prognóstico Resultado do Tratamento Trombose Intracraniana Trombose Venosa Valor Preditivo dos Testes Intracranial Thrombosis Predictive Value of Tests Prognosis Treatment Outcome Venous Thrombosis
Ano:2017
País:Portugal
Tipo de documento:artigo
Tipo de acesso:unknown
Instituição associada:Sociedade Portuguesa de Medicina Interna
Idioma:português
Origem:Revista Portuguesa de Medicina Interna
Descrição
Resumo:Introduction: Cerebral venous thrombosis (CVT) is a rare disease that affects mainly young people. The importance of recanalizationis controversial but it is related to residual symptoms/ signs. This study aims to calculate the incidence of CVT, to evaluatethe importance of recanalization and to define its predictive factors.Material and Methods: This is a retrospective observational study involving patients with CVT diagnosed between 2004 to 2014 in Braga Hospital. Functional assessment was based on the modified Rankin scale. Recanalization was defined as thepresence of venous flow in all vessels, including residual. A descriptive statistical analysis was conducted and used test t Student(t), Mann-Whitney U(U), chi-square(χ2) or Fisher’s exact test a binary logistic regression was used for predictive model. It wasrecognized statistical significance p < 0.05.Results: The incidence of CVT was estimated at 1.82 cases per 100 000 person-years. The recanalization was associated with the functional evaluation at 6 (Fisher’s exact test, p < 0.001, φc =0.511) and 12 months (Fisher’s exact test, p = 0.001, φc =0.480), inability to six (Fisher’s exact test, p = 0.024,φ = 0.305) and 12 months (Fisher’s exact test, p = 0.023,φ = 0.305), and the residual symptoms/signals at 3 months (χ2(1) = 23.46, p < 0.001,φ = 0.605). The obtained regression model included the following predictive variables age, arterial hypertension, dyslipidemia, altered state of consciousness and new residual symptoms/signs. This was statistically significant (χ2(5) = 37.43, p < 0.001), with a sensitivity of 90.0% and specificity of 70.8%. New residual symptoms/signs is the best predictor of no recanalization (OR = 33.33).Discussion and Conclusion: The recanalization has an important role in prognosis; it was possible to predict its occurrence basedon five variables.