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Health Care Encounters Prior to Hospitalization for Cerebral Venous Thrombosis Patients
Zeina Waheed1, Thalia S Field2, Lily W Zhou2
1School of Public Health, University of British Columbia, Vancouver, BC, Canada.
Insights
Over half of patients with cerebral venous thrombosis (CVT) had a healthcare visit within a week of hospitalization. Women were more likely to have outpatient encounters before admission, suggesting diagnostic opportunities.
Area of Science:
- Neurology
- Public Health
- Healthcare Analytics
Background:
- Cerebral venous thrombosis (CVT) symptoms can be nonspecific and gradually worsen, complicating early diagnosis.
- Analyzing pre-hospitalization healthcare interactions may reveal opportunities for earlier CVT detection.
Purpose of the Study:
- To investigate the frequency and types of healthcare encounters in the week preceding hospitalization for incident cerebral venous thrombosis (CVT).
- To identify potential risk factors associated with these pre-hospitalization encounters.
Main Methods:
- Population-based cohort study (2000-2017) using linked administrative data in British Columbia.
- Descriptive analysis of healthcare encounters (outpatient and inpatient) within 7 and 3 days prior to CVT hospitalization.
- Multivariable logistic regression to examine risk factors for prior healthcare encounters.
Main Results:
- 554 patients diagnosed with CVT were included (mean age 50.9 years, 55.4% female).
- Over half (57.9%) of patients had ≥1 outpatient encounter within 7 days before hospitalization.
- Women had significantly more outpatient encounters (OR = 1.79) in the week preceding admission.
Conclusions:
- A significant proportion of patients with incident CVT have healthcare encounters shortly before hospitalization.
- Women more frequently accessed outpatient care in the days leading up to CVT admission, highlighting a potential window for earlier diagnosis.
Background:
Unlike other causes of stroke, symptoms in cerebral venous thrombosis (CVT) can be nonspecific at onset with gradual worsening over time. To explore potential opportunities for earlier diagnosis, we analyzed healthcare interactions in the week prior to hospitalization for patients admitted with incident CVT in British Columbia (BC).
Methods:
We constructed a population-based cohort (2000-2017) using linked patient-level administrative data to identify patients aged ≥18 diagnosed with CVT in BC. We used descriptive analysis to describe the frequency and types of healthcare encounters within the 7 and 3 days prior to hospitalization. Multivariable logistic regression modeling was performed to examine risk factors associated with prior encounters.
Results:
The cohort included 554 patients (mean age 50.9 years, 55.4% female). Within the 7 days prior to CVT hospitalization, 57.9% of patients had ≥1 outpatient encounter and 5.6% had ≥1 inpatient encounter. In the 3 days prior to hospitalization, 46.8% of patients had ≥1 outpatient encounter and 2.0% had ≥1 inpatient encounter. Women more frequently had outpatient interactions within 7 days (64.8% women vs. 35.2% men, p < 0.001) and 3 days (51.8% vs. 48.2%, p = 0.01) before admission. Common provider specialties for outpatient encounters were general practice (58.0%), emergency (8.3%) and neurology (5.7%). Females had higher odds (OR = 1.79) of having ≥1 outpatient encounter after adjusting for confounding.
Conclusions:
Within our Canadian cohort, over half of patients had a healthcare encounter within 7 days before their hospitalization with incident CVT. Women more commonly had an outpatient encounter preceding hospital admission.
