Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes

OBJECTIVES:. 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 MAI...

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Autores principales:	Rohit Patel, MD, Muhammad A. B. Chowdhury, MPH, Sarah Gul, MD, Brenda G. Fahy, MD, Andres Gonzalez, MD, Desmond Fitzpatrick, MD, Giuliano DePortu, MD, Emily Weeks, MD, Marie-Carmelle Elie-Turenne, MD, Samirah Ocampo, BS, Sameer Ponnaluri, BS, Michael A. Pizzi, DO, PhD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/c2c7e075f6d34a4586780a37140965ee
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spelling	oai:doaj.org-article:c2c7e075f6d34a4586780a37140965ee2021-11-25T07:56:59ZUltrasound of Optic Nerve Sheath Diameter and Stroke Outcomes2639-802810.1097/CCE.0000000000000565https://doaj.org/article/c2c7e075f6d34a4586780a37140965ee2021-11-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000565https://doaj.org/toc/2639-8028OBJECTIVES:. 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.Rohit Patel, MDMuhammad A. B. Chowdhury, MPHSarah Gul, MDBrenda G. Fahy, MDAndres Gonzalez, MDDesmond Fitzpatrick, MDGiuliano DePortu, MDEmily Weeks, MDMarie-Carmelle Elie-Turenne, MDSamirah Ocampo, BSSameer Ponnaluri, BSMichael A. Pizzi, DO, PhDWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 3, Iss 11, p e0565 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Rohit Patel, MD Muhammad A. B. Chowdhury, MPH Sarah Gul, MD Brenda G. Fahy, MD Andres Gonzalez, MD Desmond Fitzpatrick, MD Giuliano DePortu, MD Emily Weeks, MD Marie-Carmelle Elie-Turenne, MD Samirah Ocampo, BS Sameer Ponnaluri, BS Michael A. Pizzi, DO, PhD Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes
description	OBJECTIVES:. 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.
format	article
author	Rohit Patel, MD Muhammad A. B. Chowdhury, MPH Sarah Gul, MD Brenda G. Fahy, MD Andres Gonzalez, MD Desmond Fitzpatrick, MD Giuliano DePortu, MD Emily Weeks, MD Marie-Carmelle Elie-Turenne, MD Samirah Ocampo, BS Sameer Ponnaluri, BS Michael A. Pizzi, DO, PhD
author_facet	Rohit Patel, MD Muhammad A. B. Chowdhury, MPH Sarah Gul, MD Brenda G. Fahy, MD Andres Gonzalez, MD Desmond Fitzpatrick, MD Giuliano DePortu, MD Emily Weeks, MD Marie-Carmelle Elie-Turenne, MD Samirah Ocampo, BS Sameer Ponnaluri, BS Michael A. Pizzi, DO, PhD
author_sort	Rohit Patel, MD
title	Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes
title_short	Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes
title_full	Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes
title_fullStr	Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes
title_full_unstemmed	Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes
title_sort	ultrasound of optic nerve sheath diameter and stroke outcomes
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/c2c7e075f6d34a4586780a37140965ee
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Ultrasound of Optic Nerve Sheath Diameter and Stroke Outcomes

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