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01-10-2014 | Original Article

Association Between Optic Nerve Sheath Diameter and Mortality in Patients with Severe Traumatic Brain Injury

Authors: Mypinder S. Sekhon, Paul McBeth, Jie Zou, Lu Qiao, Leif Kolmodin, William R. Henderson, Steve Reynolds, Donald E. G. Griesdale

Published in: Neurocritical Care | Issue 2/2014

Abstract

Purpose

Increased intracranial pressure (ICP) is associated with worse outcomes following traumatic brain injury (TBI). Studies have confirmed that ICP is correlated with optic nerve sheath diameter (ONSD) on ultrasound. The aim of our study was to assess the independent relationship between ONSD measured using CT and mortality in a population of patients admitted with severe TBI.

Methods

We conducted a retrospective cohort study of patients with a TBI requiring ICP monitoring admitted to the ICU between April 2006 and May 2012 to two neurotrauma centers. ONSD was independently measured by two physicians blinded to patient outcomes. Multivariable logistic regression modeling was used to assess an association between ONSD and hospital mortality.

Results

A total of 220 patients were included in the analysis. Overall, the cohort had a mean age of 35 (SD 17) years and 171 of 220 (79 %) were male. The median admission GCS was 6 (IQR 3–8). Intra-class correlation coefficient between raters for ONSD measurements was 0.92 (95 % CI 0.90–0.94, P < 0.0001). On multivariable analysis, each 1 mm increase in ONSD was associated with a twofold increase in hospital mortality (OR 2.0, 95 % CI 1.2–3.2, P = 0.007). Using linear regression, ONSD was independently associated with increased ICP in the first 48 h after admission (β = 4.4, 95 % CI 2.5–6.3, P < 0.0001).

Conclusions

In patients with TBI, ONSD measured on CT scanning was independently associated with ICP and mortality.

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Title: Association Between Optic Nerve Sheath Diameter and Mortality in Patients with Severe Traumatic Brain Injury
Authors: Mypinder S. Sekhon
Paul McBeth
Jie Zou
Lu Qiao
Leif Kolmodin
William R. Henderson
Steve Reynolds
Donald E. G. Griesdale
Publication date: 01-10-2014
Publisher: Springer US
Published in: Neurocritical Care / Issue 2/2014
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-014-0003-y

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Springer Medicine

Association Between Optic Nerve Sheath Diameter and Mortality in Patients with Severe Traumatic Brain Injury

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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