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Abstract 197: Association of Blood‐Based Biomarkers with Functional Outcomes in Cerebral Venous Sinus Thrombosis
Abstract   Open access   Peer reviewed

Abstract 197: Association of Blood‐Based Biomarkers with Functional Outcomes in Cerebral Venous Sinus Thrombosis

L Cruz, P Kalakoti, A Rodriguez-Calienes, J Gao, M Galecio-Castillo, N Mor, V Cano Nigenda, A Mercado, J Huynh, A Manazir, …
Stroke: vascular and interventional neurology, Vol.4(S1)
11/01/2024
DOI: 10.1161/SVIN.04.suppl_1.197
PMCID: PMC12774020
url
https://doi.org/10.1161/SVIN.04.suppl_1.197View
Published (Version of record) Open Access

Abstract

IntroductionBlood‐based biomarkers such as the neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and systemic immune‐inflammation index (SII) are associated with poor outcomes in intracerebral hemorrhage, ischemic strokes, and pulmonary embolism. However, their prognostic role in cerebral venous sinus thrombosis (CVST) remains underexplored. This study evaluates the association of NLR, PLR, and SII with functional outcomes in patients with CVST.MethodsWe conducted a multicentric study of patients with consecutive CVST admitted at two tertiary care university hospitals, the University of Iowa Healthcare and the National Institute of Neurology and Neurosurgery (INNN), between 2004 and 2024. Blood samples were obtained within the first 24 hours after admission. The primary outcome measures were poor functional outcome, defined as a modified Rankin Scale (mRS) score of 3‐6 at discharge. Empirical cutoff values for the inflammatory biomarkers were determined by maximizing Youden's index (YI) from the ROC curves. Multivariable logistic regression models assessed the association of predictive cut‐off values for NLR, PLR and SII with functional outcome while adjusting for patient demographics, clinical and imaging characteristics.ResultsA total of 453 patients with CVST were included, with a median age of 40 years (interquartile range [IQR]: 28–56); 66% were women. All patients received acute anticoagulation at admission. The median (IQR) values for NLR, PLR, and SII index were 4.56 (2.57–7.94), 0.16 (0.11–0.23), and 1090.76 (650.9–4222.4), respectively. YI cut‐offs were 5.23 for NLR (65% sensitivity, 67% specificity), 146.4 for PLR (67% sensitivity, 53% specificity), and 861.3 for the SII index (78% sensitivity, 49% specificity). In multivariable analysis adjusting age, gender, race, clinical (altered mental status; seizures; motor deficits) and imaging characteristics (ICH; venous infarction; cerebral edema), NLR above 5.23 (aOR: 2.26; 95% CI: 1.31‐ 3.90; p=0.003), PLR above 146.4 (aOR: 2.03; 95% CI: 1.15‐ 3.57; p=0.015), and SII above 861.3 (aOR: 1.84; 95% CI: 1.02‐ 3.34; p=0.043) were associated with poor functional outcomes at discharge.[Figure 1]ConclusionInflammatory biomarkers at admission such as the NLR, PLR, and SII are associated with poor functional outcomes in patients with CVST. The proposed cutoffs warrant validation in prospective studies and may be helpful in early stratification of high risk CVST patients that might do poorly despite acute anticoagulation.
 Biomarkers Thrombosis

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