{"title":"The Clinical Importance of Optic Nerve Sheath Diameter in Patients with Traumatic Brain Injury: Preliminary Report.","authors":"Burcu Avci Ozbalik, Tugba Bingol Tanriverdi, Hafize Gulsah Ozcan, Melek Gura Celik","doi":"10.4274/MMJ.galenos.2022.42966","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>The enlargement of ONSD on initial CT was detected to be associated with increased in-hospital mortality in patients with severe TBI.</p>","PeriodicalId":37427,"journal":{"name":"Medeniyet medical journal","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/2a/medj-37-320.PMC9808856.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medeniyet medical journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4274/MMJ.galenos.2022.42966","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract
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.
目的:外伤性脑损伤(TBI)是一种严重的健康问题，与死亡率增加有关。在严重TBI病例中，预测预后是至关重要的。视神经鞘直径增大(ONSD)显示颅内压增高，预后较差。在这项研究中，我们旨在评估ONSD在严重TBI患者中的预后价值。方法:对44例重度脑外伤患者进行回顾性研究。患者分为两组:幸存者(n=17)和非幸存者(n=27)。记录所有患者的基线特征、临床资料、入院时格拉斯哥昏迷评分(GCS)、脑计算机断层扫描(CT)结果、损伤严重程度评分(ISS)和马歇尔评分。ONSD在距眼球3mm处计算，紧靠巩膜下方。结果:非幸存者初始CT上的ONSD明显高于幸存者(6.83±1.40 vs. 6.40±1.36)。结论:检测到初始CT上ONSD的增大与严重TBI患者住院死亡率增加有关。
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The Medeniyet Medical Journal (Medeniyet Med J) is an open access, peer-reviewed, and scientific journal of Istanbul Medeniyet University Faculty of Medicine on various academic disciplines in medicine, which is published in English four times a year, in March, June, September, and December by a group of academics. Medeniyet Medical Journal is the continuation of Göztepe Medical Journal (ISSN: 1300-526X) which was started publishing in 1985. It changed the name as Medeniyet Medical Journal in 2015. Submission and publication are free of charge. No fees are asked from the authors for evaluation or publication process. All published articles are available online in the journal website (www.medeniyetmedicaljournal.org) without any fee. The journal publishes intradisciplinary or interdisciplinary clinical, experimental, and basic researches as well as original case reports, reviews, invited reviews, or letters to the editor, Being published since 1985, the Medeniyet Med J recognizes that the best science should lead to better lives based on the fact that the medicine should serve to the needs of society, and knowledge should transform society. The journal aims to address current issues at both national and international levels, start debates, and exert an influence on decision-makers all over the world by integrating science in everyday life. Medeniyet Med J is committed to serve the public and influence people’s lives in a positive way by making science widely accessible. Believing that the only goal is improving lives, and research has an impact on people’s lives, we select the best research papers in line with this goal.
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