Introduction:
Cerebral venous thrombosis (CVT) is nowadays considered a disease with a good outcome in most cases, but in the past these patients were believed to have a grave prognosis. This apparent decline in mortality has not been investigated systematically
Methods:
We performed a systematic review of the literature. Older studies were identified from books and by scanning reference lists. Studies with 40 CVT patients or more that minimally reported mortality at discharge were eligible. Care was taken to exclude duplicate publications based on the same patient cohort. Studies were ranked according to the year halfway the period of patient inclusion. If no time span was reported, we assumed a period of inclusion of 10 years prior to the year of publication.
Results:
Of 4.585 potentially eligible studies, 74 fulfilled the selection criteria and were included in the analysis. The majority of studies were retrospective (80%) and single-center (59%). In total, 23.031 patients were included in the analysis. The number of patients per study varied from 40 to 11.400 (median 79). Seven studies included only children. There was a significant inverse correlation between mortality and year of patient recruitment (Pearson’s correlation coefficient -0.70, p<0.001, figure). In a sensitivity analysis, exclusion of retrospective studies, pediatric studies, single-center studies, or studies from low income countries did not significantly alter the correlation.
Conclusions:
There is a clear trend in declining mortality among patients with CVT over time. Possible explanations include better diagnosis (with identification of less severe cases), improved treatment and a declining incidence of infection related CVT.
Pattern of Venous Thrombosis in Cancer Patients: Frequency and Survival Effect; Single Center Experience
