Relationship between optic nerve sheath diameter on initial brain computed tomography and neurologic outcome in post-cardiac arrest patients with therapeutic hypothermia

Abstract Background: Optic nerve sheath diameter (ONSD) is effective in predicting the neurologic outcome of patients with post-cardiac arrest (CA) return of spontaneous circulation. This study aimed to investigate the effect of ONSD changes before and after CA on neurologic outcomes in patients with return of spontaneous circulation after CA using brain computed tomography (CT).Methods: We included patients who were hospitalized after CA and underwent pre- and post-CA brain CT from January 2001 to September 2020. They were divided into the good and poor neurologic outcome (GNO and PNO, respectively) groups based on the neurologic outcome at hospital discharge. We performed between-group comparisons of the amount and rate of post-CA changes on brain CT. Moreover, we calculated the area under the curve to determine the predictive value of ONSD changes for neurologic outcomes.Results: We included 96 enrolled patients; among them, 25 had GNO. The amount of change was significantly higher in the PNO group than in the GNO group (0.63 vs. 0.30 mm; p = 0.030). Moreover, there was a higher rate of change in the PNO group than in the GNO group (12.29 vs. 5.26 %; p = 0.041). The AUC for predicting PNO was 0.64 (95% CI = 0.53–0.73; p = 0.04) and patients with a rate of ONSD change > 27.2% had PNO with specificity and positive predictive values of 100%.Conclusion: The amount and rate of ONSD changes on brain CT were significantly associated with the neurologic outcomes in post-CA patients. ONSD changes may predict neurologic outcomes in post-CA patients.

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Predictive Utility of Changes in Optic Nerve Sheath Diameter after Cardiac Arrest for Neurologic Outcomes

10.20944/preprints202105.0167.v1 ◽

2021 ◽

Author(s):

Heekyung Lee ◽

Joonkee Lee ◽

Hyungoo Shin ◽

Changsun Kim ◽

Hyuk Joong Choi ◽

...

Keyword(s):

Cardiac Arrest ◽

Optic Nerve ◽

Predictive Value ◽

Optic Nerve Sheath Diameter ◽

Rate Of Change ◽

Optic Nerve Sheath ◽

Neurologic Outcome ◽

Brain Ct ◽

Neurologic Outcomes ◽

Nerve Sheath

Optic nerve sheath diameter (ONSD) can help predict the neurologic outcome of patients with post-cardiac arrest (CA) return of spontaneous circulation (ROSC). We aimed to investigate the effect of ONSD changes before and after CA on neurologic outcomes in patients with ROSC after CA using brain computed tomography (CT). The study included patients hospitalized after CA, who had undergone pre- and post-CA brain CT from January 2001 to September 2020. The patients were divided into good and poor neurologic outcome (GNO and PNO, respectively) groups based on the neurologic outcome at hospital discharge. We performed between-group comparisons of the amount and rate of ONSD changes on brain CT and calculated the area under the curve (AUC) to determine their predictive value for neurologic outcomes. Among the 96 enrolled patients, 25 had GNO. Compared to the GNO group, the PNO group showed significantly higher amount (0.30 vs. 0.63 mm; p=0.030) and rate of change (5.26 vs. 12.29 %; p=0.041). The AUC for predicting PNO was 0.64 (95% CI=0.53–0.73; p=0.04) and patients with a rate of ONSD change &gt;27.2% had PNO with 100% specificity and positive predictive value. Hence, ONSD changes may predict neurologic outcomes in patients with post-CA ROSC.

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Diagnostic performance of optic nerve sheath diameter for predicting neurologic outcome in post-cardiac arrest patients: A systematic review and meta-analysis

Resuscitation ◽

10.1016/j.resuscitation.2019.03.004 ◽

2019 ◽

Vol 138 ◽

pp. 59-67 ◽

Cited By ~ 7

Author(s):

Sun Hwa Lee ◽

Seong Jong Yun

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

Optic Nerve ◽

Diagnostic Performance ◽

Meta Analysis ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Neurologic Outcome ◽

Nerve Sheath

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Optic nerve sheath diameter on computed tomography not predictive of neurological status post-cardiac arrest

CJEM ◽

10.1017/cem.2016.348 ◽

2016 ◽

Vol 19 (3) ◽

pp. 181-185 ◽

Cited By ~ 6

Author(s):

Barret Rush ◽

Andrew Wormsbecker ◽

Landon Berger ◽

Katie Wiskar ◽

Mypinder S. Sekhon ◽

...

Keyword(s):

Computed Tomography ◽

Cardiac Arrest ◽

Optic Nerve ◽

Neurological Outcome ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Good Outcome ◽

Nerve Sheath ◽

Outcome Group ◽

Poor Neurological Outcome

AbstractObjectiveOptic nerve sheath diameter (ONSD) measured on a head computed tomography (CT) has been suggested as a potential prognostic factor for poor neurological outcome after cardiac arrest. We performed a single centre retrospective cohort analysis to further investigate this relationship.MethodsAll patients >18 years of age admitted to St. Paul’s Hospital in Vancouver, Canada who survived a cardiac arrest and had a CT scan of the head within 48 hours were included in the analysis.ResultsA total of 72 patients met inclusion criteria for the study; 54 (75.0%) of the patients had a poor neurological outcome, whereas 18 (25.0%) patients were discharged from the hospital with a good outcome. A CT head was obtained for patients in the good outcome group in a mean time of 9.3 hours (SD 10.0) compared to 10.2 hours (SD 11.2) for the poor outcome group (p=0.75). There was no difference in average ONSD observed between the two outcome groups (6.66 mm SD 0.78 v. 6.60 mm SD 0.82, p=0.77). Multiple logistic regression failed to show any association between ONSD and neurological outcome when adjusted for all other covariates (OR 1.32 95% CI 0.40-4.34, p=0.65). Setting an ONSD threshold of >8 mm (OR 2.32, 95% CI 0.14-39.40, p=0.55) or >7 mm (OR 0.28, 95% CI 0.03-2.77, p=0.28) also failed to show any association on neurological outcome.ConclusionThere was no observed difference in ONSD between those with a good neurological outcome and those with a poor outcome. ONSD was not an independent predictor of poor neurological outcome.

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