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KMID : 0385920170280040334
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Journal of the Korean Society of Emergency Medicine
2017 Volume.28 No. 4 p.334 ~ p.344
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Availability of the Optic Nerve Sheath Diameter Measured by Using Brain CT in Intracranial Hemorrhage
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Yu Jae-Kwang
Kim Yang-Weon
Kang Ji-Hun
Yoon Yoo-Sang
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Abstract
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Purpose: This study was designed to evaluate the applicability of optic nerve sheath diameter (ONSD), as measured by a brain CT, in intracranial hemorrhage patients. We assumed that ONSD can be used to make surgical decisions and be considered as a predictive factor for mild intracranial hemorrhage (survival and neurologic outcomes) compared with the Glasgow Coma Scale (GCS) score.
Method: This retrospective study included 457 patients between January 2016 and September. They were divided into two groups: Those with GCS of between 13 and 15, and those with GCS of below 12. ONSD measurements were taken using a brain computed tomography in the axial view. Using SPSS Statistics ver. 20.0, ONSD was analyzed by a binary logistic regression analysis. Receiver operating characteristics (ROC) curves were used to find the cut-off value that maximized the sum of sensitivity and specificity in both groups to evaluate the feasibility of using ONSD for surgical decision and as a predictive factor (survival and neurologic outcomes).
Results: The mean ONSD in mild hemorrhage patients was 5.43 mm. The odd ratio in the mild intracranial hemorrhage group for surgical decision was 5.030. The area under the ROC curve of mean ONSD in mild hemorrhage for surgical decision was 0.789. The cut-off value was 5.46 mm; sensitivity was 81.6% and Specificity was 75.0%. Positive and negative predictive values were 80.7% and 76.4%, respectively.
Conclusion: The mean ONSD, when compared with the GCS score, is a valuable factor for making surgical decisions in cases of mild intracranial hemorrhage.
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KEYWORD
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Intracranial hemorrhages, Intracranial pressure, Optic nerve, Glasgow Coma Scale
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