Koopman et al developed a score to predict outcome for a patient with cerebral venous thrombosis (CVT). The score can help to identify a patient who may benefit from more aggressive management. The authors are from University Medical Center Groningen in The Netherlands and Universitair Ziekenhuis Brussel in Belgium.
Patient selection: cerebral vein thrombosis
Outcome: death or disability (modified Rankin scale > 2)
The parameters are from the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). The assigned points are derived from the natural logarithm of the hazard ratio for each parameter being multiplied by 10 then rounded to the nearest integer.
Parameters:
(1) age in years
(2) gender
(3) intracranial hemorrhage
(4) mental status disorder
(5) Glasgow Coma Score (GCS)
(6) malignancy
(7) deep cerebral venous thrombosis
(8) central nervous system (CNS) infection
|
Parameter |
Finding |
Points |
|
age in years |
<= 37 years of age |
0 |
|
|
> 37 years of age |
7 |
|
gender |
female |
0 |
|
|
male |
5 |
|
intracranial hemorrhage |
absent |
0 |
|
|
present |
6 |
|
mental status disorder |
absent |
0 |
|
|
present |
7 |
|
Glasgow coma score |
>= 9 |
0 |
|
|
< 9 |
10 |
|
malignancy |
absent |
0 |
|
|
present |
11 |
|
deep cerebral venous thrombosis |
absent |
0 |
|
|
present |
11 |
|
CNS infection |
absent |
0 |
|
|
present |
12 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 69 (but only a few patients have scores > 35)
• A score >= 14 was associated with risk for poor outcome.
Performance:
• The area under the ROC curve was 0.81.
• The sensitivity was 88% and specificity 70%.
• The negative predictive value was 96%.
• The positive predictive value was 39%.
Specialty: Hematology Oncology, Clinical Laboratory, Neurology, Ophthalmology, Otolaryngology
