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

Resuscitation ◽  
2019 ◽  
Vol 138 ◽  
pp. 59-67 ◽  
Author(s):  
Sun Hwa Lee ◽  
Seong Jong Yun
2021 ◽  
Author(s):  
Heekyung Lee ◽  
Joonkee Lee ◽  
Hyungoo Shin

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.


Author(s):  
Heekyung Lee ◽  
Joonkee Lee ◽  
Hyungoo Shin ◽  
Changsun Kim ◽  
Hyuk Joong Choi ◽  
...  

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 >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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