Abstract:
In managing cerebral venous sinus thrombosis (CVT), the standard approach has been administering parenteral anticoagulation for at least five days, despite limited supporting evidence. This study aimed to determine the optimal duration of parenteral anticoagulation for CVT patients and its potential impact on their functional outcomes upon discharge. This retrospective observational cohort study was conducted across multiple healthcare centers and included adult CVT patients who received varying durations of parenteral anticoagulation: less than 5 days (n = 25) or 5 days or more (n = 16). The primary focus was on the duration of acute anticoagulation treatment, with secondary endpoints including hospital stay length and functional outcomes. The study found that a shorter duration of anticoagulation treatment (< 5 days) was linked to more favorable outcomes, as measured by the modified Rankin Scale (mRS) (68% vs. 25%, RR = 0.37, CI 0.15-0.90, p = 0.007). However, regression analysis showed non statistically significant associations for all variables except gender. Female patients were significantly more likely to receive a shorter duration of anticoagulation (Odds Ratio: 2.6, 95% CI: 2.2-3.1, P-Value: <0.001). These findings suggest a potential connection between shorter anticoagulation duration (< 5 days) and improved CVT patient outcomes, as indicated by their mRS scores at discharge. The observed relationship between female gender and shorter anticoagulation duration warrants further exploration. Nevertheless, caution is necessary when interpreting these findings due to the small sample size and specific patient characteristics. Further research in a larger and more diverse cohort is essential to validate these results and understand their implications fully.
摘要:
在处理脑静脉窦血栓形成(CVT)时,标准的方法是给予至少5天的肠胃外抗凝药物,尽管支持证据有限。本研究旨在确定CVT患者肠外抗凝治疗的最佳持续时间及其对出院后功能结局的潜在影响。这项回顾性观察性队列研究是在多个医疗中心进行的,包括接受不同持续时间肠外抗凝治疗的成年CVT患者:少于5天(n=25)或5天或更长时间(n=16)。主要关注急性抗凝治疗的持续时间,次要终点包括住院时间和功能结局。研究发现,抗凝治疗的持续时间较短(<5天)与更有利的结局有关。通过改良的兰金量表(mRS)测量(68%与25%,RR=0.37,CI0.15-0.90,p=0.007)。然而,回归分析显示,除性别外,所有变量的相关性均无统计学意义.女性患者更有可能接受较短的抗凝治疗(赔率比:2.6,95%CI:2.2-3.1,P值:<0.001)。这些研究结果表明,较短的抗凝持续时间(<5天)与CVT患者预后改善之间存在潜在联系。如出院时的mRS评分所示。观察到的女性性别与抗凝持续时间较短之间的关系值得进一步探索。然而,由于样本量小和特定的患者特征,在解释这些发现时需要谨慎。在更大,更多样化的队列中进行进一步研究对于验证这些结果并充分理解其含义至关重要。