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.

中文翻译：

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脑静脉血栓形成患者在转为口服抗凝药物之前是否需要至少输注 5 天的普通肝素？回顾性图表审查

摘要

在治疗脑静脉窦血栓 (CVT) 时，尽管支持证据有限，但标准方法是肠外抗凝治疗至少五天。本研究旨在确定 CVT 患者肠外抗凝的最佳持续时间及其对出院后功能结果的潜在影响。这项回顾性观察队列研究在多个医疗中心进行，纳入接受不同持续时间的肠外抗凝治疗的成年 CVT 患者：少于 5 天 ( n  = 25) 或 5 天或以上 ( n  = 16)。主要关注点是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果。研究发现，根据改良Rankin量表（mRS）测量，较短的抗凝治疗持续时间（<5天）与更有利的结果相关（68% vs. 25%，RR = 0.37，CI 0.15–0.90，p  = 0.007)。然而，回归分析显示除性别之外的所有变量均无统计学显着性关联。女性患者接受较短抗凝持续时间的可能性明显更大（优势比：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 患者预后的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较短抗凝持续时间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。为了验证这些结果并充分理解其含义，必须对更大、更多样化的队列进行进一步研究。