Cerebral Venous Thrombosis in Traumatic Brain Injury: A Population-Based Cross-Sectional Study of 640 Patients

Abstract

Background

Cerebral venous thrombosis (CVT) is a rare but serious complication of traumatic brain injury (TBI), yet the implications of this association remain poorly understood. This study explores the demographics, risk factors, and clinical outcomes of patients with both TBI and CVT (CVT-TBI).

Methods

The National Inpatient Sample (NIS) was queried from 2016–2020 for adult patients with a primary diagnosis of TBI and concurrent CVT. Chi-squared tests and logistic regression were used to compare demographic, clinical, and outcome variables of CVT-TBI and TBI-only patients.

Results

Of the 1,583,915 TBI patients identified between 2016–2020, 640 (0.04%) had concurrent CVT. CVT-TBI patients were younger (47.94 vs 61.81; p < 0.001), more likely to have Medicaid (30.5% vs 14.1%; p < 0.001), less likely to be female (31.3% vs 39.0%; p < 0.001), and less likely to be Caucasian (60.9% vs 68.1%; p < 0.001). Multivariate analysis demonstrated age (OR = 0.98; p < 0.001), skull fracture (OR = 3.741; p < 0.001), epidural hematoma (OR = 1.407; p = 0.012), subdural hematoma (OR = 2.395; p < 0.001), and subarachnoid hemorrhage (OR = 1.415; p < 0.001) as CVT risk factors. CVT-TBI patients experienced more severe clinical courses involving mechanical ventilation (21.9% vs 10.4%; p < 0.001), cerebral herniation (6.3% vs 3.7%; p = 0.001), and being comatose (45.3% vs 30.7%; p < 0.001) and were more likely to undergo decompressive hemicraniectomy (4.7% vs 1.1%; p < 0.001), tracheostomy or percutaneous endoscopic gastrostomy tube placement (3.9% vs 1.5%; p < 0.001), and develop long-term sequelae, including seizures (10.9% vs 4.2%; p < 0.001) and hydrocephalus (7.0% vs 1.7%; p < 0.001). After matching, there was a significant difference in discharge home (OR = 1.806; p = 0.018), but no significant difference in discharge to a skilled nursing home (OR = 1.068; p = 0.449), short term rehabilitation facility (OR = 0.850; p = 0.500), or inpatient mortality (OR = 1.134; p = 0.500).

Conclusions

This population-based retrospective analysis unveils distinctive demographic and clinical features of CVT-TBI patients, emphasizing the need for tailored risk assessment and management strategies to improve outcomes for this subset of TBI patients.

Keywords

cerebral venous thrombosis traumatic brain injury national inpatient sample demographic characteristics clinical outcomes

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