Incidence, Treatment Strategies and Prognosis of Cerebral Venous Thrombosis in British Columbia, Canada

Project number: 
19-118
Approval date: 
Wednesday, March 4, 2020
Principal Investigator: 
Zhou,Lily
Institution: 
Vancouver General Hospital (VGH)
Funding Agency: 
Canadian Institutes of Health Research(CIHR),Canadian Institutes of Health Research(CIHR)
Datasets requested: 
Consolidation file (BC Ministry of Health)
Deaths (BC Vital Statistics Agency)
PharmaNet
Medical Services Plan (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
Perinatal Services BC
consolidation - census geocodes
bc cancer
Hospital Separations (BC Ministry of Health)
Research objective: 

OBJECTIVES:
1: Validate sensitivity and specificity of ICD 9/10 codes in identifying CVT from administrative data in British Columbia.
2: Use BC administrative data to estimate incidence of CVT, associated demographics and major risk factors (age, sex, peripartum status, malignancy status, use of hormonal contraceptives or hormone replacement), and prognosis (mortality, length of hospital stay, re-hospitalization related to intracranial bleeding, seizures and recurrent VTE).
3: Use BC Medical Services Plan data to assess interactions with the health care system in the 4 weeks prior to diagnosis to estimate delays in diagnosis of CVT.
4: Using BC PharmaNet prescription data to assess choice of anticoagulant and duration of therapy for CVT, and to explore differences in duration and choice of therapy by prescriber (specialty [e.g. neurologist, hematologist, internist], prescribers geographic location) and patient characteristics (e.g. age, sex, peripartum status, malignancy status).
5: Use BC PharmaNet prescription data to estimate proportion of patients requiring anti-seizure medications after CVT diagnosis, and describe the choice of agent and duration of therapy.
6: Identify the resources used by CVT patients in their journey through hospital and post-discharge to better assess their care utilization and cost of care

HYPOTHESIS:
1: Identifying CVT cases using ICD 9 and 10 codes from administrative data has good sensitivity and specificity in British Columbia.
2: Demographics and major risk factors (age, sex, peripartum status, malignancy status, use of hormonal contraceptives and hormone replacement), and prognosis (mortality, length of hospital stay, re-hospitalization related to intracranial bleeding, seizures and recurrent VTE) are similar to other international CVT cohorts
3: There is significant delay leading up to the diagnosis of CVT by 4-9 days.
4: It is anticipated the majority of patients will remain on anticoagulation for 6-12s with differences in treatment patterns in anticoagulation use between treating physician of different specialityspecialty
5: The prognosis of secondary seizures after CVT has yet been unexplored. It is anticipated at least a portion will remit and be taken off seizure medication, possibly within 6-12 months of initial seizure.
6. Patient on different forms of anticoagulation will display different forms of care utilization with possibly significant difference in costs


Page last revised: July 14, 2020