Evidence map›Paper›PMID 39915720›Full record

SynthesisBMC neurology2025

Key prognostic risk factors linked to poor functional outcomes in cerebral venous sinus thrombosis: a systematic review and meta-analysis.

Lili Lin, Senfeng Liu, Wei Wang, Xiao-Kuo He, Muhammad Hibatullah Romli, Ruthpackiavathy Rajen Durai

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lili Lin *Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia.ORCID http://orcid.org/0000-0001-5086-8113
Senfeng Liu *Faculty of Environment and Public Health, Xiamen Huaxia University, Xiamen, 361000, People's Republic of China.ORCID http://orcid.org/0009-0006-1559-4392
Wei WangDepartment of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China. wwdwt3396@163.com.ORCID http://orcid.org/0000-0002-9171-9269
Xiao-Kuo HeDepartment of Neurology, The Fifth Xiamen Hospital, Xiamen, 361000, People's Republic of China.ORCID http://orcid.org/0000-0002-2533-0124
Muhammad Hibatullah RomliFaculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia. hibatullah.romli@gmail.com.ORCID http://orcid.org/0000-0003-4361-8102
Ruthpackiavathy Rajen DuraiFaculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia. ruthpackiavaty@upm.edu.my.ORCID http://orcid.org/0000-0001-6804-8092

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCerebral venous sinus thrombosis is a rare stroke with several clinical manifestations. Several studies have identified prognostic risk factors associated with poor functional outcomes and established predictive models. This systematic review and meta-analysis assessed the overall effect size of all prognostic risk factors.

methodsA systematic review was conducted to explore all prognostic risk factors in studies published from the initial to June 2024 among 5 Databases included PubMed / Medline, Scopus, EBSCOhost, Web of Science, and Cochran Library. The quality of the methodology was analyzed using the Newcastle-Ottawa Scale. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 29.

resultsSixty-four studies involving 18,958 participants with a mean age of 38.46 years and females 63.03% were included in the quantitative meta-analysis. Functional outcomes were primarily measured using the Modified Rankin Scale (mRS), with scores ≥ 2 or ≥ 3 indicating poor outcomes in 35.00% and 60.00% of studies, respectively. For general information, age (InOR = 0.98, 95% CI 0.53-1.43), intracranial hemorrhage (OR = 3.79, 95% CI 2.77-5.20), and ischemic infarction (OR = 3.18, 95% CI 2.40-4.23) were associated with poor functional outcomes. For general and neurological symptoms, headache (OR = 0.22, 95% CI 0.17-0.29), seizure (OR = 2.74, 95% CI 1.76-4.27), focal deficit (OR = 4.72, 95% CI 3.86-5.78), coma (OR = 11.60, 95% CI 6.12-21.98), and consciousness alteration (OR = 7.07, 95% CI 4.15-12.04) were outstanding factors. The blood biomarkers of NLR (log OR = 1.72, 95% CI 0.96-2.47), lymphocytes (Cohen's d = -0.63, 95 CI -0.78--0.47), and D-dimer (lnOR = 1.34, 95% CI 0.87-1.80) were the three most frequently reported factors. Parenchymal lesion (OR = 4.71, 95% CI 1.12-19.84) and deep cerebral venous thrombosis (OR = 6.30, 95% CI 2.92-13.63) in radiological images were two frequently reported factors. CVST patients with cancer (OR = 3.87, 95% CI 2.95-5.07) or high blood glucose levels (OR = 3.52, 95% CI 1.61-7.68) were associated with poor functional outcomes. In the meta-regression analysis, ischemic infarction (P = 0.032), consciousness alteration (P < 0.001), and NLR (P = 0.015) were associated with mRS prediction.

conclusionsPooled effect sizes revealed that ischemic infarction, headache, neurological focal deficit, lymphopenia, and cancer were significantly associated with poor functional outcomes, with low to moderate heterogeneity. Consciousness alterations/deterioration and deep cerebral venous thrombosis were also significant prognostic factors, albeit with substantial heterogeneity. The meta-regression analysis showed that the effect sizes of consciousness alterations/deterioration and NLR increased with worsening mRS scores. Other notable risk factors included age, intracranial hemorrhage, seizures, coma, D-dimer, parenchymal lesions, and hyperglycemia. This systematic review provides a comprehensive overview of the prognostic risk factors for poor functional outcomes in patients undergoing CVST, which can guide clinical decision-making and future research.

trial registrationThis systematic review and meta-analysis has been registered with INPLASY (International Platform of Registered Systematic Review and Meta-analysis Protocols), and the registration number is INPLASY202480072. The registration period is 14 August 2024.

Indexed as

Sinus Thrombosis, IntracranialFemaleHumansPrognosisRisk FactorsCerebral venous sinus thrombosisFunctional outcomePrognosisStroke

Identifiers

PMID39915720
PMCPMC11800514

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.