Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes.

Autor:	Patel R; Department of Emergency Medicine, University of Florida, Gainesville, FL., Chowdhury MAB; Department of Emergency Medicine, University of Florida, Gainesville, FL., Gul S; Department of Surgery, Yale University, New Haven, CT., Fahy BG; Division of Neurocritical Care, Department of Anesthesia, University of Florida, Gainesville, FL., Gonzalez A; Department of Ophthalmology, University of Southern California Roski Eye Institute, Los Angeles, CA., Fitzpatrick D; Department of Emergency Medicine, University of Florida, Gainesville, FL., DePortu G; Department of Emergency Medicine, University of Florida, Gainesville, FL., Weeks E; Department of Emergency Medicine, University of Florida, Gainesville, FL., Elie-Turenne MC; Department of Emergency Medicine, University of Florida, Gainesville, FL., Ocampo S; Division of Neurocritical Care, Department of Neurology, University of Florida, Gainesville, FL., Ponnaluri S; Division of Neurocritical Care, Department of Neurology, University of Florida, Gainesville, FL., Pizzi MA; Division of Neurocritical Care, Department of Neurology, University of Florida, Gainesville, FL.
Jazyk:	angličtina
Zdroj:	Critical care explorations [Crit Care Explor] 2021 Nov 11; Vol. 3 (11), pp. e0565. Date of Electronic Publication: 2021 Nov 11 (Print Publication: 2021).
DOI:	10.1097/CCE.0000000000000565
Abstrakt:	We aimed at utilizing ocular ultrasound to determine its utility in predicting outcomes among stroke patients. Design: Single-center prospective observational study. Setting: Emergency department and ICUs. Patients: Patients suspected of stroke. Interventions: None. Measures and Main Results: Bilateral optic nerve sheath diameter was measured on arrival and within the first 2 days of admission. Outcomes were inpatient survival, Cerebral Performance Category, and modified Rankin Scale at 3 and 6 months. Analysis was conducted using descriptive statistics, paired t test, chi-square test. Eighty-six patients were enrolled with ischemic or hemorrhagic stroke. Mean age was 67.2 years (± 15 yr), and 54.7% of patients were male. There was no difference between left and right eye measurements ( p = 0.467 and p = 0.903, respectively) or between longitudinal and transverse measurements (transverse p = 0.163 and longitudinal p = 0.270). Mean optic nerve sheath diameter differed in patients who survived versus died prior to discharge in both ischemic (0.53 vs 0.58 cm; p = 0.009) or hemorrhagic stroke (0.57 vs 0.62 cm; p = 0.019). For every 0.1 cm increase in optic nerve sheath diameter, odds ratio for death were 4.2 among ischemic stroke (95% CI, 1.32-13.64; p = 0.015), and odds ratio 6.2 among ischemic or hemorrhagic patients (95% CI, 1.160-33.382; p = 0.033). Increased optic nerve sheath diameter correlated ( r = 0.44; p < 0.0001) with poor functional outcomes measured as modified Rankin Scale scores of 3-6 at 6 months. Conclusions: Elevations in optic nerve sheath diameter were associated with increased inhospital mortality and poor functional outcome at 6 months. Optic nerve sheath diameter may serve as a noninvasive marker of inhospital mortality and functional outcome. Further multicenter prospective trials for evaluating and treating optic nerve sheath diameter in ischemic and hemorrhagic strokes are warranted. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
Databáze:	MEDLINE
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