B.2 Time from symptom onset and number of health care encounters prior to diagnosis of cerebral venous thrombosis

T Field, LW Zhou, V. Dizonno, M Almekhlafi, F Bala, B. Graham, LA Sposato, J Mandzia, G Medvedev, B. Buck, MI Boulos, A Tkach, A. Pikula, D Blacquiere, K Perera, C. Odier, M. Hill
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Abstract

Background: Cerebral venous thrombosis (CVT)most commonly affects younger women. Diagnosis may be delayed due to its distinct presentation and demographic profile compared to other stroke types. Methods: We examined delays to diagnosis of CVT in the SECRET randomized trial and TOP-SECRET parallel registry. Adults diagnosed with symptomatic CVT within <14 days were included. We examined time to diagnosis and number of health care encounters prior to diagnosis and associations with demographics, clinical and radiologic features and functional and patient-reported outcomes (PROMS) at days 180&365. Results: Of 103 participants, 68.9% were female; median age was 45 (IQR 31.0-61.0). Median time from symptom onset to diagnosis was 4 (1-8) days. Diagnosis on first presentation to medical attention was made in 60.2%. The difference in time to diagnosis for single versus multiple presentations was on the order of days (3[1-7] vs. 5[2-11.75], p=0.16). Women were likelier to have multiple presentations (OR 2.53; 95% CI1.00-6.39; p=0.05) and longer median times to diagnosis (5[2-8]days vs. 2[1-4.5] days; p=0.005). However, this was not associated with absolute or change in functional, or any patient reported, outcome measures (PROMs) at days 180&365. Conclusions: Diagnosis of CVT was commonly delayed; women were likelier to have multiple presentations. We found no association between delayed diagnosis and outcomes.
B.2 从症状出现到确诊脑静脉血栓形成的时间和就医次数
背景:脑静脉血栓(CVT)最常见于年轻女性。与其他卒中类型相比,脑静脉血栓的表现和人口统计学特征与众不同,因此可能会延误诊断。方法:我们研究了 SECRET 随机试验和 TOP-SECRET 并行登记中 CVT 诊断延迟的情况。纳入了在 <14 天内诊断出有症状的 CVT 的成人。我们研究了诊断时间、诊断前的医疗就诊次数以及与人口统计学、临床和放射学特征、180 天和 365 天后的功能和患者报告结果 (PROMS) 的关系。结果:在 103 名参与者中,68.9% 为女性;年龄中位数为 45 岁(IQR 31.0-61.0)。从症状出现到确诊的中位时间为 4(1-8)天。60.2%的患者在首次就诊时得到诊断。单次发病与多次发病的诊断时间相差天数(3[1-7] vs. 5[2-11.75],P=0.16)。女性更有可能多次发病(OR 2.53;95% CI1.00-6.39;p=0.05),诊断中位时间也更长(5[2-8]天 vs. 2[1-4.5]天;p=0.005)。然而,这与第 180 天和第 365 天的功能或任何患者报告的结果指标(PROMs)的绝对值或变化无关。结论:CVT的诊断通常会延迟;女性更容易出现多种表现。我们发现延迟诊断与结果之间没有关联。
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