Abstract DP068: Cognition, mood, anxiety and return to work after decompressive surgery for severe cerebral venous thrombosis

Introduction: Two-thirds of patients are alive and one third are functionally independent one year after decompressive surgery for severe cerebral venous thrombosis (CVT). However, their neuropsychiatric and professional outcomes are unknown. This substudy of the DECOMPRESS2 multicenter cohort study aimed to evaluate cognition, mood, and return to work in surviving patients. Methods: DECOMPRESS2 was a prospective international cohort study which included 118 patients with severe CVT treated by decompressive neurosurgery. Patients were evaluated at admission, discharge, 6 and 12 months. In this substudy, survivors were assessed at 6 and 12 months using the Mini-Mental State Examination (MMSE; normal ≥24/30), the Hospital Anxiety and Depression Scale (HADS-anxiety and HADS-depression subscales; normal ≤8/21), and a questionnaire on return to paid work. Paired t tests were used to compare MMSE and HADS scores at 6 and 12 months. McNemar tests were used to compare paired proportions for MMSE and HADS. Results: There were 78 survivors at 6 months and 73 at 12 months. MMSE scores were available for 67 patients (median age 38 years; 45 women) at 6 months and for 63 at 12 months. At 6 months, 35 (52.2%) and at 12 months, 33 (52.4%) scored MMSE ≥24. MMSE scores improved significantly from 6 to 12 months (Table 1). HADS scores were available for 63 patients at 6 months and 61 at 12 months. At 6 months, 32 (50.8%) had HADS-anxiety scores <8, increasing to 44 (72.1%) at 12 months ( p = 0.002). HADS-depression scores <8 were recorded in 37 patients (58.7%) at 6 months and in 44 (72.1%) at 12 months, but this difference was not statistically significant ( p = 0.052). HADS scores did improve significantly from 6 to 12 months (Table 1). Paid work status data were available for 71 survivors, of whom 33 (46.5%) were employed at the time of CVT onset, 27 (38.0%) full-time. At 6 months, 369 (4.3) were in full-time paid employment. At 12 months, 9/67 patients (13.4%) were working, including 5 in full-time positions. Among patients with mRS 0-2 at 12 months, 22/34 (64.7%) scored ≥24 on MMSE and 8 (23.5%) were working. Conclusions: The findings of this study suggest that favorable neuropsychiatric outcomes are achievable following decompressive surgery for severe CVT. MMSE and HADS scores improved from 6 to 12 months. Despite the severity of CVT, 1 in 7 patients was working one year after surgery.