Objective To test the hypothesis that racial-, age- and sex-specific incidence of cerebral venous thrombosis (CVT) has increased in the United States over the last decade. Methods In this retrospective cohort study, validated International Classification of Disease codes were used to identify all new cases of CVT (n=5,567) in the State Inpatients Database (SID) of New York and Florida (2006-2016). A new CVT case was defined as first hospitalization for CVT in the SID without prior CVT hospitalization. CVT counts were combined with annual Census data to compute incidence. Joinpoint regression was used to evaluate trends in incidence over time. Results From 2006-2016, annual age and sex-standardized incidence of CVT in cases/million population ranged from 13.9-20.2, but incidence varied significantly by sex (females: 20.3-26.9; males 6.8-16.8) and by age/sex (females 18-44yo: 24.0-32.6%; males: 18-44yo: 5.3-12.8). Incidence also differed by race (Blacks:18.6-27.2; Whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006-2016 but most of this increase was driven by increase in all age groups of males (combined annualized percentage change (APC) 9.2%, p-value <0.001), females 45-64 yo (APC 7.8%, p-value <0.001) and females ≥65 yo (APC 7.4%, p-value <0.001). Incidence in females 18-44 yo remained unchanged over time. Conclusion: CVT incidence is disproportionately higher in blacks compared to other races. New CVT hospitalizations increased significantly over the last decade mainly in males and older females. Further studies are needed to determine whether this increase represents true increase from changing risk factors or artefactual increase from improved detection.

Supplemental tables