# Impact of anaemia severity on functional outcome in patients with cerebral venous thrombosis: a DOAC-CVT substudy

## TL;DR

This study found that moderate to severe anemia at admission predicts worse recovery in patients with cerebral venous thrombosis.

## Contribution

The study is the first to show that anemia severity correlates with poor outcomes in cerebral venous thrombosis patients.

## Key findings

- Anaemia was associated with poor functional outcome (mRS 3–6) in CVT patients.
- Moderate to severe anaemia had a stronger association with poor outcomes than mild anaemia.
- Anaemia was not significantly linked to mortality in CVT patients.

## Abstract

Anaemia is an established risk factor for poor outcome in intracerebral haemorrhage and ischaemic stroke. We examined whether anaemia predicts poor outcome in cerebral venous thrombosis (CVT).

We used data of the DOAC-CVT study, which was an international, prospective observational cohort study in adult patients with CVT that ran from January 2021 to January 2024. Anaemia at admission was defined according to World Health Organization criteria. Poor outcome was defined as modified Rankin Scale (mRS) 3–6 at 6-months. Binary logistic regression, adjusted for age, recent delivery/puerperium, income country, cancer and intracranial haemorrhage, was applied.

Of 619 patients in DOAC-CVT, 583 patients were included, of whom 157 (27%) had anaemia. Compared to patients without anaemia, patients with anaemia were slightly younger (median age 40 vs. 42 years), more often female (76% vs. 59%), from middle income countries (36% vs. 21%), more often had intracranial haemorrhage (48% vs. 32%) and cancer (5% vs. 2%). Anaemia was associated with poor functional outcome (mRS 3–6, 10% vs. 5%, aOR: 2.20, 95% Cl, 1.01–4.81), but not with mortality (3% vs. 1%, aOR: 3.54, 95% Cl, 0.68–18.31). When stratified by severity, moderate to severe anaemia was associated with poor functional outcome (aOR 2.88, 95% Cl, 1.14–7.38), but mild anaemia was not (aOR 1.64, 95% Cl, 0.60–4.55).

Anaemia at admission, especially moderate to severe, is a predictor for poor functional outcome in patients with CVT, highlighting the need for further studies on potential interventions.

Graphical Abstract