Zhu S, Cheng C, Wang LL, Zhao DJ, Zhao YL, Liu XZ. Prognostic values of optic nerve sheath diameter for comatose patients with acute stroke: An observational study. World J Clin Cases 2022; 10(33): 12175-12183 [PMID: 36483822 DOI: 10.12998/wjcc.v10.i33.12175]
Corresponding Author of This Article
Xian-Zeng Liu, PhD, Professor, Department of Neurology, Peking University International Hospital, No. 1 Life Science Park Life Road, Changping District, Beijing 102206, China. liuxianzeng@pkuih.edu.cn
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sha Zhu, Xian-Zeng Liu, Department of Neurology, Peking university international hospital, Beijing 102206, China
Chao Cheng, Dian-Jiang Zhao, Department of Radiology, Peking University International Hospital, Beijing 102206, China
Liu-Liu Wang, Department of Intensive Care Unit, Peking University International Hospital, Beijing 102206, China
Yuan-Li Zhao, Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing 100070, China
Author contributions: Zhu S participated in the design of the study, analysis of the data, and drafting of the manuscript; Cheng C, and Zhao DJ participated in measuring optic nerve sheath diameter and eyeball transverse diameter; Wang LL contributed to the collection of clinical data; Zhao YL contributed to the guidance of the research; Liu XZ contributed to the guidance of the research and review of the manuscript; The author(s) have read and approved the final version of the manuscript.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of Peking University International Hospital [Approval No. 2021-001 (BMR)].
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: If there is a need, you can find the corresponding author to share data at any time.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xian-Zeng Liu, PhD, Professor, Department of Neurology, Peking University International Hospital, No. 1 Life Science Park Life Road, Changping District, Beijing 102206, China. liuxianzeng@pkuih.edu.cn
Received: July 24, 2022 Peer-review started: July 24, 2022 First decision: August 22, 2022 Revised: September 13, 2022 Accepted: October 26, 2022 Article in press: October 26, 2022 Published online: November 26, 2022 Processing time: 121 Days and 22.2 Hours
Abstract
BACKGROUND
Optic nerve sheath diameter (ONSD) measurement is one of the non-invasive methods recommended for increased intracranial pressure (ICP) monitoring.
AIM
This study aimed to evaluate the roles of optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) ratio in predicting prognosis of death in comatose patients with acute stroke during their hospitalization.
METHODS
A total of 67 comatose patients with acute stroke were retrospectively recruited. The ONSD and ETD were measured by cranial computed tomography (CT) scan. All patients underwent cranial CT scan within 24 h after coma onset. Patients were divided into death group and survival group according to their survival status at discharge. The differences of the ONSD and ONSD/ETD ratio between the two groups and their prognostic values were compared.
RESULTS
The ONSD and ONSD/ETD ratio were 6.07 ± 0.72 mm and 0.27 ± 0.03 in the comatose patients, respectively. The ONSD was significantly greater in the death group than that in the survival group (6.32 ± 0.67 mm vs 5.65 ± 0.62 mm, t = 4.078, P < 0.0001). The ONSD/ETD ratio was significantly higher in the death group than that in the survival group (0.28 ± 0.03 vs 0.25 ± 0.02, t = 4.625, P < 0.0001). The area under the receiver operating characteristic curve was 0.760 (95%CI: 0.637-0.882, P < 0.0001) for the ONSD and 0.808 (95%CI: 0.696-0.920, P < 0.0001) for the ONSD/ETD ratio.
CONCLUSION
The mortality increased in comatose patients with acute stroke when the ONSD was > 5.7 mm or the ONSD/ETD ratio was > 0.25. Both indexes could be used as prognostic tools for comatose patients with acute stroke. The ONSD/ETD ratio was more stable than the ONSD alone, which would be preferred in clinical practice.
Core Tip: Optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) were correlated with intracranial pressure and prognosis. This study aimed to evaluate the roles of ONSD and ONSD/ETD ratio in predicting prognosis of death in comatose patients with acute stroke during hospitalization. Total 67 comatose patients were retrospectively recruited. ONSD and ETD were measured by cranial computed tomography scans within 24 h after coma onset. It was found that the mortality increased when ONSD > 5.7 mm or ONSD/ETD ratio > 0.25. The ONSD/ETD ratio was more stable than ONSD alone, which be preferred in clinical practice.
