A scoring tool to predict mortality and dependency after cerebral venous thrombosis

Erik Lindgren, Katarzyna Krzywicka, Maria A. de Winter, Mayte Sánchez Van Kammen, Mirjam R. Heldner, Sini Hiltunen, Diana Aguiar de Sousa, Maryam Mansour, Patrícia Canhão, Esme Ekizoğlu, Miguel Rodrigues, Elisa Martins Silva, Carlos Garcia-Esperon, Valentina Arnao, Paolo Aridon, Naaem Moin Simaan, Suzanne M. Silvis, Susanna M. Zuurbier, Adrian Scutelnic, Mine SezginAndrey Marisovich Alasheev, Andrey Smolkin, Daniel Guisado-Alonso, Nilufer Yesilot, Miguel Barboza, Masoud Ghiasian, Ronen R. Leker, Antonio Arauz, Marcel Arnold, Jukka Putaala, Turgut Tatlisumak, Jonathan M. Coutinho, Katarina Jood

Research output: Contribution to journalArticlepeer-review


Background and purpose: A prognostic score was developed to predict dependency and death after cerebral venous thrombosis (CVT) to identify patients for targeted therapy in future clinical trials. Methods: Data from the International CVT Consortium were used. Patients with pre-existent functional dependency were excluded. Logistic regression was used to predict poor outcome (modified Rankin Scale score 3–6) at 6 months and Cox regression to predict 30-day and 1-year all-cause mortality. Potential predictors derived from previous studies were selected with backward stepwise selection. Coefficients were shrunk using ridge regression to adjust for optimism in internal validation. Results: Of 1454 patients with CVT, the cumulative number of deaths was 44 (3%) and 70 (5%) for 30 days and 1 year, respectively. Of 1126 patients evaluated regarding functional outcome, 137 (12%) were dependent or dead at 6 months. From the retained predictors for both models, the SI2NCAL2C score was derived utilizing the following components: absence of female-sex-specific risk factor, intracerebral hemorrhage, infection of the central nervous system, neurological focal deficits, coma, age, lower level of hemoglobin (g/l), higher level of glucose (mmol/l) at admission, and cancer. C-statistics were 0.80 (95% confidence interval [CI] 0.75–0.84), 0.84 (95% CI 0.80–0.88) and 0.84 (95% CI 0.80–0.88) for the poor outcome, 30-day and 1-year mortality model, respectively. Calibration plots indicated a good model fit between predicted and observed values. The SI2NCAL2C score calculator is freely available at www.cerebralvenousthrombosis.com. Conclusions: The SI2NCAL2C score shows adequate performance for estimating individual risk of mortality and dependency after CVT but external validation of the score is warranted.

Original languageEnglish
Pages (from-to)2305-2314
Number of pages10
JournalEuropean Journal of Neurology
Issue number8
StatePublished - Aug 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.


  • cerebral venous thrombosis
  • dependency
  • follow-up
  • mortality
  • outcome
  • prognosis
  • risk score
  • stroke


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