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Prognostic effect of frailty in cerebral venous thrombosis

Alis J Dicpinigaitis1, Fawaz Al-Mufti2, Christian A Bowers3

  • 1Department of Neurology, New York Presbyterian Hospital - Weill Cornell Medical Center, New York, NY, USA.

Journal of the Neurological Sciences
|September 18, 2025
PubMed

Insights

Frailty significantly impacts outcomes in cerebral venous thrombosis (CVT). Increased frailty, measured by the Risk Analysis Index (RAI), is linked to poorer outcomes and higher NIHSS scores in CVT patients.

Area of Science:

  • Neurology
  • Geriatrics
  • Vascular Medicine

Background:

  • Cerebral venous thrombosis (CVT) research often overlooks frailty.
  • CVT predominantly affects younger populations, making frailty assessment less common.
  • This study investigates frailty's role in CVT outcomes using a large national dataset.

Purpose of the Study:

  • To evaluate the association between frailty and adverse outcomes in patients with CVT.
  • To determine if frailty, quantified by the Risk Analysis Index (RAI), predicts poor outcomes in CVT.
  • To assess the combined predictive power of frailty and neurological deficit scores for CVT outcomes.

Main Methods:

  • Utilized hospitalization records from the National Inpatient Sample (2016-2020) for CVT cases.
  • Stratified patients based on frailty levels using the Risk Analysis Index (RAI).
  • Employed multivariable logistic regression to analyze the effect of frailty on poor outcomes (non-routine discharge).

Main Results:

  • Identified 3265 CVT hospitalizations; 14.2% were frail and 4.9% very frail.
  • Poor outcomes occurred in 58.7% of patients, increasing with higher frailty tiers.
  • All frailty tiers were significantly associated with poor outcomes; a combined RAI-NIHSS model showed strong predictive discrimination (c-statistic=0.828).

Conclusions:

  • Frailty is a significant predictor of short-term outcomes in CVT.
  • The Risk Analysis Index (RAI) effectively quantifies frailty's impact on CVT prognosis.
  • Combining RAI and NIHSS scores offers a reliable method for predicting CVT patient outcomes.
Abstract

Keywords:
Cerebral venous thrombosisDatabaseFrailtyOutcomeStroke

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