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

Heekyung Lee, Joonkee Lee, Hyungoo Shin, Changsun Kim, Hyuk-Joong Choi and Bo-Seung Kang
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Heekyung Lee: Department of Emergency Medicine, Hanyang University Guri Hospital, 153, Gyeongchunro-ro, Guri, Gyeonggi-do 11923, Korea
Joonkee Lee: Department of Emergency Medicine, Hanyang University Guri Hospital, 153, Gyeongchunro-ro, Guri, Gyeonggi-do 11923, Korea
Hyungoo Shin: Department of Emergency Medicine, Hanyang University Guri Hospital, 153, Gyeongchunro-ro, Guri, Gyeonggi-do 11923, Korea
Changsun Kim: Department of Emergency Medicine, Hanyang University Guri Hospital, 153, Gyeongchunro-ro, Guri, Gyeonggi-do 11923, Korea
Hyuk-Joong Choi: Department of Emergency Medicine, Hanyang University Guri Hospital, 153, Gyeongchunro-ro, Guri, Gyeonggi-do 11923, Korea
Bo-Seung Kang: Department of Emergency Medicine, Hanyang University Guri Hospital, 153, Gyeongchunro-ro, Guri, Gyeonggi-do 11923, Korea

IJERPH, 2021, vol. 18, issue 12, 1-10

Abstract: The optic nerve sheath diameter (ONSD) can help predict the neurologic outcomes 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 between January 2001 and September 2020. The patients were divided into good and poor neurologic outcome (GNO and PNO, respectively) groups based on their neurologic outcome at hospital discharge. We performed between-group comparisons of the amount and rate of ONSD changes in 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 with the GNO group, the PNO group showed a significantly higher amount (0.30 vs. 0.63 mm; p = 0.030) and rate (5.26 vs. 12.29%; p = 0.041) of change. The AUC for predicting PNO was 0.64 (95% confidence interval = 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.

Keywords: heart arrest; optic nerve sheath diameter; patient outcome assessment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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