Abstract
Background Cerebral venous sinus thrombosis (CVST) is a rare condition, accounting for 0.5% to 3% of all strokes. The standard treatment is anticoagulation, whereas thrombectomy is reserved for severe or refractory cases. Although guidelines recommend thrombectomy for refractory CVST, large, randomized trials are still needed. This study aims to compare the outcomes of CVST hospitalizations with and without thrombectomy.Methods We abstracted data from the Nationwide Readmissions Database from 2016 to 2021 to identify CVST hospitalizations. The primary objective was to compare 30- and 90-day all-cause readmissions between patients who underwent thrombectomy and those who did not. Secondary objectives included inpatient mortality, routine discharge, length of stay, and hospital costs. To assess whether all-cause readmissions, inpatient mortality, and routine discharge differed by the receipt of a thrombectomy, logistic regression models were estimated. To assess whether length of stay and hospital cost differed by the receipt of a thrombectomy, log-normal models were estimated. Multivariable models were estimated to adjust for age and comorbidity burden.Results Hospitalizations carrying a CVST diagnosis and receiving a thrombectomy had a 30-day all-cause readmission rate of 8.78% compared with 14.21% for hospitalizations without a thrombectomy (P = 0.018; Table 1). Similarly, hospitalizations with thrombectomy had a 90-day all-cause readmission rate of 13.06% compared with 22.97% for hospitalizations without a thrombectomy (P = 0.003; Table 1). However, hospitalizations with thrombectomy were associated with 2.92 times greater inpatient mortality, 2.02 times longer stays, 3.22 times greater costs, and 62% lower odds of routine discharge compared with hospitalizations without thrombectomy.Conclusion Our findings showed lower 30- and 90-day all-cause readmissions in hospitalizations with CVST who underwent thrombectomy, pointing to an association between thrombectomy and long-term benefit. The higher inpatient mortality, costs, and length of stay associated with thrombectomy indicate the need to be highly selective in offering this intervention for patients with CVST.