The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary Report
Objective: Traumatic brain injury (TBI) is a serious health problem that is related to an increased mortality. In cases of severe TBI, the prediction of prognosis is essential. The enlargement of the optic nerve sheath diameter (ONSD) shows an increased intracranial pressure and is associated with p...
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Galenos Publishing House
2022-12-01
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| Series: | Medeniyet Medical Journal |
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| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-42966 |
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| author | Burcu AVCI OZBALIK Tugba BINGOL TANRIVERDI Hafize Gulsah OZCAN Melek GURA CELIK |
| author_facet | Burcu AVCI OZBALIK Tugba BINGOL TANRIVERDI Hafize Gulsah OZCAN Melek GURA CELIK |
| author_sort | Burcu AVCI OZBALIK |
| collection | DOAJ |
| description | Objective: Traumatic brain injury (TBI) is a serious health problem that is related to an increased mortality. In cases of severe TBI, the prediction of prognosis is essential. The enlargement of the optic nerve sheath diameter (ONSD) shows an increased intracranial pressure and is associated with poor outcomes. In this study, we aimed to evaluate the prognostic value of ONSD in patients with severe TBI.
Methods: Forty-four patients with severe TBI were retrospectively enrolled in the study. The patients were divided into two groups: survivors (n=17) and non-survivors (n=27). Baseline characteristics, clinical data, Glasgow coma scale (GCS) on hospital admission, brain computed tomography (CT) results, injury severity score (ISS), and Marshall score were recorded for all patients. ONSD was calculated at 3 mm distance from the globe, immediately below the sclera.
Results: The ONSD on the initial CT was significantly higher in non-survivors compared with survivors (6.83+-1.40 vs. 6.40+-1.36, p<0.05). In addition, ISS and Marshall score were significantly higher, whereas GCS was significantly lower in non-survivors. ONSD was positively correlated with Marshall score (r=0.332, p<0.05). Receiver operating characteristics analysis demonstrated that ONSD ≥6.61 had a sensitivity of 70.4% and specificity of 64.7% for predicting mortality. It was shown that ONSD ≥6.61 had a 4.3-fold increased risk for in-hospital mortality (odds ratio: 4.35; 95% confidence interval: 1.195-15.865; p<0.05).
Conclusions: The enlargement of ONSD on initial CT was detected to be associated with increased in-hospital mortality in patients with severe TBI. |
| format | Article |
| id | doaj-art-3e39a499295f4be0be4a7574bac5b2d4 |
| institution | Kabale University |
| issn | 2149-2042 2149-4606 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Medeniyet Medical Journal |
| spelling | doaj-art-3e39a499295f4be0be4a7574bac5b2d42025-01-30T07:07:34ZengGalenos Publishing HouseMedeniyet Medical Journal2149-20422149-46062022-12-0137432032610.4274/MMJ.galenos.2022.42966MEDJ-42966The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary ReportBurcu AVCI OZBALIK0Tugba BINGOL TANRIVERDI1Hafize Gulsah OZCAN2Melek GURA CELIK3Iskenderun State Hospital, Clinic of Anesthesiology and Reanimation, Hatay, TurkeyUniversity of Health Sciences Turkey, Mehmet Akif Inan Training and Research Hospital, Clinic of Anesthesiology and Reanimation, Sanliurfa, TurkeyAcibadem Ankara Hospital, Clinic of Anesthesiology and Reanimation, Ankara, TurkeyIstanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Anesthesiology and Reanimation, Istanbul, TurkeyObjective: Traumatic brain injury (TBI) is a serious health problem that is related to an increased mortality. In cases of severe TBI, the prediction of prognosis is essential. The enlargement of the optic nerve sheath diameter (ONSD) shows an increased intracranial pressure and is associated with poor outcomes. In this study, we aimed to evaluate the prognostic value of ONSD in patients with severe TBI. Methods: Forty-four patients with severe TBI were retrospectively enrolled in the study. The patients were divided into two groups: survivors (n=17) and non-survivors (n=27). Baseline characteristics, clinical data, Glasgow coma scale (GCS) on hospital admission, brain computed tomography (CT) results, injury severity score (ISS), and Marshall score were recorded for all patients. ONSD was calculated at 3 mm distance from the globe, immediately below the sclera. Results: The ONSD on the initial CT was significantly higher in non-survivors compared with survivors (6.83+-1.40 vs. 6.40+-1.36, p<0.05). In addition, ISS and Marshall score were significantly higher, whereas GCS was significantly lower in non-survivors. ONSD was positively correlated with Marshall score (r=0.332, p<0.05). Receiver operating characteristics analysis demonstrated that ONSD ≥6.61 had a sensitivity of 70.4% and specificity of 64.7% for predicting mortality. It was shown that ONSD ≥6.61 had a 4.3-fold increased risk for in-hospital mortality (odds ratio: 4.35; 95% confidence interval: 1.195-15.865; p<0.05). Conclusions: The enlargement of ONSD on initial CT was detected to be associated with increased in-hospital mortality in patients with severe TBI.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-42966optic nerve sheath diametertraumatic brain injurymarshall scoreinjury severity scoremortality |
| spellingShingle | Burcu AVCI OZBALIK Tugba BINGOL TANRIVERDI Hafize Gulsah OZCAN Melek GURA CELIK The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary Report Medeniyet Medical Journal optic nerve sheath diameter traumatic brain injury marshall score injury severity score mortality |
| title | The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary Report |
| title_full | The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary Report |
| title_fullStr | The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary Report |
| title_full_unstemmed | The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary Report |
| title_short | The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary Report |
| title_sort | clinical importance of optic nerve sheath diameter in patients with traumatic brain injury preliminary report |
| topic | optic nerve sheath diameter traumatic brain injury marshall score injury severity score mortality |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-42966 |
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