Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes
OBJECTIVES:. We aimed at utilizing ocular ultrasound to determine its utility in predicting outcomes among stroke patients. DESIGN:. Single-center prospective observational study. SETTING:. Emergency department and ICUs. PATIENTS:. Patients suspected of stroke. INTERVENTIONS:. None. MEASURES AND MAI...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2021-11-01
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| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000565 |
| _version_ | 1818405937263673344 |
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| author | Rohit Patel, MD Muhammad A. B. Chowdhury, MPH Sarah Gul, MD Brenda G. Fahy, MD Andres Gonzalez, MD Desmond Fitzpatrick, MD Giuliano DePortu, MD Emily Weeks, MD Marie-Carmelle Elie-Turenne, MD Samirah Ocampo, BS Sameer Ponnaluri, BS Michael A. Pizzi, DO, PhD |
| author_facet | Rohit Patel, MD Muhammad A. B. Chowdhury, MPH Sarah Gul, MD Brenda G. Fahy, MD Andres Gonzalez, MD Desmond Fitzpatrick, MD Giuliano DePortu, MD Emily Weeks, MD Marie-Carmelle Elie-Turenne, MD Samirah Ocampo, BS Sameer Ponnaluri, BS Michael A. Pizzi, DO, PhD |
| author_sort | Rohit Patel, MD |
| collection | DOAJ |
| description | OBJECTIVES:. We aimed at utilizing ocular ultrasound to determine its utility in predicting outcomes among stroke patients.
DESIGN:. Single-center prospective observational study.
SETTING:. Emergency department and ICUs.
PATIENTS:. Patients suspected of stroke.
INTERVENTIONS:. None.
MEASURES AND MAIN RESULTS:. Bilateral optic nerve sheath diameter was measured on arrival and within the first 2 days of admission. Outcomes were inpatient survival, Cerebral Performance Category, and modified Rankin Scale at 3 and 6 months. Analysis was conducted using descriptive statistics, paired t test, chi-square test. Eighty-six patients were enrolled with ischemic or hemorrhagic stroke. Mean age was 67.2 years (± 15 yr), and 54.7% of patients were male. There was no difference between left and right eye measurements (p = 0.467 and p = 0.903, respectively) or between longitudinal and transverse measurements (transverse p = 0.163 and longitudinal p = 0.270). Mean optic nerve sheath diameter differed in patients who survived versus died prior to discharge in both ischemic (0.53 vs 0.58 cm; p = 0.009) or hemorrhagic stroke (0.57 vs 0.62 cm; p = 0.019). For every 0.1 cm increase in optic nerve sheath diameter, odds ratio for death were 4.2 among ischemic stroke (95% CI, 1.32–13.64; p = 0.015), and odds ratio 6.2 among ischemic or hemorrhagic patients (95% CI, 1.160–33.382; p = 0.033). Increased optic nerve sheath diameter correlated (r = 0.44; p < 0.0001) with poor functional outcomes measured as modified Rankin Scale scores of 3–6 at 6 months.
CONCLUSIONS:. Elevations in optic nerve sheath diameter were associated with increased inhospital mortality and poor functional outcome at 6 months. Optic nerve sheath diameter may serve as a noninvasive marker of inhospital mortality and functional outcome. Further multicenter prospective trials for evaluating and treating optic nerve sheath diameter in ischemic and hemorrhagic strokes are warranted. |
| first_indexed | 2024-12-14T09:03:59Z |
| format | Article |
| id | doaj.art-c2c7e075f6d34a4586780a37140965ee |
| institution | Directory Open Access Journal |
| issn | 2639-8028 |
| language | English |
| last_indexed | 2024-12-14T09:03:59Z |
| publishDate | 2021-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj.art-c2c7e075f6d34a4586780a37140965ee2022-12-21T23:08:45ZengWolters KluwerCritical Care Explorations2639-80282021-11-01311e056510.1097/CCE.0000000000000565202111000-00016Ultrasound of Optic Nerve Sheath Diameter and Stroke OutcomesRohit Patel, MD0Muhammad A. B. Chowdhury, MPH1Sarah Gul, MD2Brenda G. Fahy, MD3Andres Gonzalez, MD4Desmond Fitzpatrick, MD5Giuliano DePortu, MD6Emily Weeks, MD7Marie-Carmelle Elie-Turenne, MD8Samirah Ocampo, BS9Sameer Ponnaluri, BS10Michael A. Pizzi, DO, PhD111 Department of Emergency Medicine, University of Florida, Gainesville, FL.1 Department of Emergency Medicine, University of Florida, Gainesville, FL.2 Department of Surgery, Yale University, New Haven, CT.3 Division of Neurocritical Care, Department of Anesthesia, University of Florida, Gainesville, FL.4 Department of Ophthalmology, University of Southern California Roski Eye Institute, Los Angeles, CA.1 Department of Emergency Medicine, University of Florida, Gainesville, FL.1 Department of Emergency Medicine, University of Florida, Gainesville, FL.1 Department of Emergency Medicine, University of Florida, Gainesville, FL.1 Department of Emergency Medicine, University of Florida, Gainesville, FL.5 Division of Neurocritical Care, Department of Neurology, University of Florida, Gainesville, FL.5 Division of Neurocritical Care, Department of Neurology, University of Florida, Gainesville, FL.5 Division of Neurocritical Care, Department of Neurology, University of Florida, Gainesville, FL.OBJECTIVES:. We aimed at utilizing ocular ultrasound to determine its utility in predicting outcomes among stroke patients. DESIGN:. Single-center prospective observational study. SETTING:. Emergency department and ICUs. PATIENTS:. Patients suspected of stroke. INTERVENTIONS:. None. MEASURES AND MAIN RESULTS:. Bilateral optic nerve sheath diameter was measured on arrival and within the first 2 days of admission. Outcomes were inpatient survival, Cerebral Performance Category, and modified Rankin Scale at 3 and 6 months. Analysis was conducted using descriptive statistics, paired t test, chi-square test. Eighty-six patients were enrolled with ischemic or hemorrhagic stroke. Mean age was 67.2 years (± 15 yr), and 54.7% of patients were male. There was no difference between left and right eye measurements (p = 0.467 and p = 0.903, respectively) or between longitudinal and transverse measurements (transverse p = 0.163 and longitudinal p = 0.270). Mean optic nerve sheath diameter differed in patients who survived versus died prior to discharge in both ischemic (0.53 vs 0.58 cm; p = 0.009) or hemorrhagic stroke (0.57 vs 0.62 cm; p = 0.019). For every 0.1 cm increase in optic nerve sheath diameter, odds ratio for death were 4.2 among ischemic stroke (95% CI, 1.32–13.64; p = 0.015), and odds ratio 6.2 among ischemic or hemorrhagic patients (95% CI, 1.160–33.382; p = 0.033). Increased optic nerve sheath diameter correlated (r = 0.44; p < 0.0001) with poor functional outcomes measured as modified Rankin Scale scores of 3–6 at 6 months. CONCLUSIONS:. Elevations in optic nerve sheath diameter were associated with increased inhospital mortality and poor functional outcome at 6 months. Optic nerve sheath diameter may serve as a noninvasive marker of inhospital mortality and functional outcome. Further multicenter prospective trials for evaluating and treating optic nerve sheath diameter in ischemic and hemorrhagic strokes are warranted.http://journals.lww.com/10.1097/CCE.0000000000000565 |
| spellingShingle | Rohit Patel, MD Muhammad A. B. Chowdhury, MPH Sarah Gul, MD Brenda G. Fahy, MD Andres Gonzalez, MD Desmond Fitzpatrick, MD Giuliano DePortu, MD Emily Weeks, MD Marie-Carmelle Elie-Turenne, MD Samirah Ocampo, BS Sameer Ponnaluri, BS Michael A. Pizzi, DO, PhD Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes Critical Care Explorations |
| title | Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes |
| title_full | Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes |
| title_fullStr | Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes |
| title_full_unstemmed | Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes |
| title_short | Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes |
| title_sort | ultrasound of optic nerve sheath diameter and stroke outcomes |
| url | http://journals.lww.com/10.1097/CCE.0000000000000565 |
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