The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage
Abstract Background We evaluated the role of optic nerve sheath diameter (ONSD) using brain computed tomography (CT) in predicting neurological outcomes of patients with subarachnoid hemorrhage (SAH). Methods This was a retrospective, multicenter, observational study of adult patients with SAH admit...
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BMC
2019-02-01
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| Series: | Critical Care |
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| Online Access: | http://link.springer.com/article/10.1186/s13054-019-2360-6 |
| _version_ | 1828421404634120192 |
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| author | Sangkil Lee Yong Oh Kim Ji Sun Baek Jeong-Am Ryu |
| author_facet | Sangkil Lee Yong Oh Kim Ji Sun Baek Jeong-Am Ryu |
| author_sort | Sangkil Lee |
| collection | DOAJ |
| description | Abstract Background We evaluated the role of optic nerve sheath diameter (ONSD) using brain computed tomography (CT) in predicting neurological outcomes of patients with subarachnoid hemorrhage (SAH). Methods This was a retrospective, multicenter, observational study of adult patients with SAH admitted between January 2012 and June 2017. Initial brain CT was performed within 12 h from onset of SAH, and follow-up brain CT was performed within 24 h from treatment of a ruptured aneurysm. Primary outcome was neurological status at 6-month follow-up assessed with the Glasgow Outcome Scale (GOS, 1 to 5). Results Among 223 SAH patients, 202 (90.6%) survived until discharge. Of these survivors, 186 (83.4%) manifested favorable neurological outcomes (GOS of 3, 4, or 5). In this study, the ONSDs in the group of patients with poor neurological outcome were significantly greater than those in the favorable neurological outcome group (all p < 0.01). Intracranial pressure (ICP) was monitored in 21 (9.4%) patients during the follow-up CT. A linear correlation existed between the average ONSD and ICP in simple correlation analysis (r = 0.525, p = 0.036). Analysis of the receiver operating characteristic curve for prediction of poor neurological outcome showed that ONSD had considerable predictive value (C-statistics, 0.735 to 0.812). In addition, the performance of a composite of Hunt and Hess grade and ONSD was increasingly associated with poor neurological outcomes than the use of each marker alone. Conclusions ONSD measured with CT may be used in combination with clinical grading scales to improve prognostic accuracy in SAH patients. |
| first_indexed | 2024-12-10T15:30:02Z |
| format | Article |
| id | doaj.art-86fc14b8a9b646daad2243e4dcf514a5 |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-12-10T15:30:02Z |
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| series | Critical Care |
| spelling | doaj.art-86fc14b8a9b646daad2243e4dcf514a52022-12-22T01:43:25ZengBMCCritical Care1364-85352019-02-012311910.1186/s13054-019-2360-6The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhageSangkil Lee0Yong Oh Kim1Ji Sun Baek2Jeong-Am Ryu3Department of Neurology, ChungBuk National University HospitalDepartment of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Ophthalmology, Konyang University, Kim’s Eye Hospital, Myung-Gok Eye Research InstituteDepartment of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background We evaluated the role of optic nerve sheath diameter (ONSD) using brain computed tomography (CT) in predicting neurological outcomes of patients with subarachnoid hemorrhage (SAH). Methods This was a retrospective, multicenter, observational study of adult patients with SAH admitted between January 2012 and June 2017. Initial brain CT was performed within 12 h from onset of SAH, and follow-up brain CT was performed within 24 h from treatment of a ruptured aneurysm. Primary outcome was neurological status at 6-month follow-up assessed with the Glasgow Outcome Scale (GOS, 1 to 5). Results Among 223 SAH patients, 202 (90.6%) survived until discharge. Of these survivors, 186 (83.4%) manifested favorable neurological outcomes (GOS of 3, 4, or 5). In this study, the ONSDs in the group of patients with poor neurological outcome were significantly greater than those in the favorable neurological outcome group (all p < 0.01). Intracranial pressure (ICP) was monitored in 21 (9.4%) patients during the follow-up CT. A linear correlation existed between the average ONSD and ICP in simple correlation analysis (r = 0.525, p = 0.036). Analysis of the receiver operating characteristic curve for prediction of poor neurological outcome showed that ONSD had considerable predictive value (C-statistics, 0.735 to 0.812). In addition, the performance of a composite of Hunt and Hess grade and ONSD was increasingly associated with poor neurological outcomes than the use of each marker alone. Conclusions ONSD measured with CT may be used in combination with clinical grading scales to improve prognostic accuracy in SAH patients.http://link.springer.com/article/10.1186/s13054-019-2360-6Optic nerve sheath diameterBrain computed tomographySubarachnoid hemorrhage |
| spellingShingle | Sangkil Lee Yong Oh Kim Ji Sun Baek Jeong-Am Ryu The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage Critical Care Optic nerve sheath diameter Brain computed tomography Subarachnoid hemorrhage |
| title | The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage |
| title_full | The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage |
| title_fullStr | The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage |
| title_full_unstemmed | The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage |
| title_short | The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage |
| title_sort | prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage |
| topic | Optic nerve sheath diameter Brain computed tomography Subarachnoid hemorrhage |
| url | http://link.springer.com/article/10.1186/s13054-019-2360-6 |
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