[국내논문]Correlation between Optic Nerve Sheath Diameter Measured by Computed Tomography and Elevated Intracranial Pressure in Patients with Traumatic Brain Injury원문보기
Purpose: The optic nerve sheath diameter (ONSD) measured by ultrasonography is among the indicators of intracranial pressure (ICP) elevation. However, whether ONSD measurement is useful for initial treatment remains controversial. Thus, this study aimed to investigate the relationship between ONSD m...
Purpose: The optic nerve sheath diameter (ONSD) measured by ultrasonography is among the indicators of intracranial pressure (ICP) elevation. However, whether ONSD measurement is useful for initial treatment remains controversial. Thus, this study aimed to investigate the relationship between ONSD measured by computed tomography (CT) and ICP in patients with traumatic brain injury (TBI). Methods: A total of 246 patients with severe trauma from January 1, 2015 until December 31, 2015 were included in the study. A total of 179 patients with brain damage with potential for ICP elevation were included in the TBI group. The remaining 67 patients comprised the non-TBI group. A comparison was made between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of ONSD when used as a screening test for the TBI group including those with TBI with midline shift (with elevated ICP). Results: The mean injury severity score (ISS) and glasgow coma scale (GCS) of all patients were $24.2{\pm}6.1$ and $5.4{\pm}0.8$, respectively. The mean ONSD of the TBI group ($5.5{\pm}1.0mm$) was higher than that of the non-TBI group ($4.7{\pm}0.6mm$). Some significant differences in age ($55.3{\pm}18.1$ vs. $49.0{\pm}14.8$, p<0.001), GCS ($11.7{\pm}4.1$ versus $13.3{\pm}3.0$, p<0.001), and ONSD ($5.5{\pm}1.0$ vs. $4.7{\pm}0.6$, p5.5 mm, measured on CT, is a good indicator of ICP elevation. However, since an ONSD is not sensitive enough to detect an increased ICP, it should only be used as one of the parameters in detecting ICP along with other screening tests.
Purpose: The optic nerve sheath diameter (ONSD) measured by ultrasonography is among the indicators of intracranial pressure (ICP) elevation. However, whether ONSD measurement is useful for initial treatment remains controversial. Thus, this study aimed to investigate the relationship between ONSD measured by computed tomography (CT) and ICP in patients with traumatic brain injury (TBI). Methods: A total of 246 patients with severe trauma from January 1, 2015 until December 31, 2015 were included in the study. A total of 179 patients with brain damage with potential for ICP elevation were included in the TBI group. The remaining 67 patients comprised the non-TBI group. A comparison was made between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of ONSD when used as a screening test for the TBI group including those with TBI with midline shift (with elevated ICP). Results: The mean injury severity score (ISS) and glasgow coma scale (GCS) of all patients were $24.2{\pm}6.1$ and $5.4{\pm}0.8$, respectively. The mean ONSD of the TBI group ($5.5{\pm}1.0mm$) was higher than that of the non-TBI group ($4.7{\pm}0.6mm$). Some significant differences in age ($55.3{\pm}18.1$ vs. $49.0{\pm}14.8$, p<0.001), GCS ($11.7{\pm}4.1$ versus $13.3{\pm}3.0$, p<0.001), and ONSD ($5.5{\pm}1.0$ vs. $4.7{\pm}0.6$, p5.5 mm, measured on CT, is a good indicator of ICP elevation. However, since an ONSD is not sensitive enough to detect an increased ICP, it should only be used as one of the parameters in detecting ICP along with other screening tests.
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문제 정의
This study aimed to determine the relationship between ONSD measured by CT and ICP elevation in patients with TBI.
Thus, this study aimed to examine the association between ONSD measured on CT and TBI. The results of this study may be necessary in the treatment of patients with TBI with elevated ICP as the ultrasound measurement of ONSD may be inaccurate based on how it was performed.
제안 방법
These results suggested that the ONSD measurement is not highly relevant to the TBI group. An ROC curve was used to analyze the correlation between TBI group and those with midline shift seen on CT scans. Results revealed an AUC of 0.
Thus, this study aimed to examine the association between ONSD measured on CT and TBI. The results of this study may be necessary in the treatment of patients with TBI with elevated ICP as the ultrasound measurement of ONSD may be inaccurate based on how it was performed. The TBI group had a mean ONSD value of 5.
대상 데이터
This study included 509 patients with injury severity score (ISS) of 15 or higher who visited the trauma center from January 1, 2015 until December 31, 2015. Of the 509 patients who underwent CT scan, 354 had injuries on the brain, chest, and abdomen.
Two hundred forty-six patients included in present study were classified into two groups: TBI group and non-TBI group. The TBI group comprised patients with extra-axial or intra-axial hematoma as determined by the abbreviated injury scale (AIS), the non-TBI group included patients without TBI as determined by the AIS (Fig.
In this study, 182 of the 246 patients were males. The mean age was 54.
이론/모형
05 denotes a statistical difference. Receiver operating characteristic (ROC) curve analysis was used to determine the correlation between ONSD and TBI or TBI with midline shift.
성능/효과
In this study, ONSD might be a less useful screening test to detect ICP elevation during initial treatment. Based on the results of the ROC analysis in the TBI group, an ONSD of 5.5 mm or more yielded a sensitivity of 46.9%. Therefore, ONSD should be used as one of the parameters in detecting ICP elevation during the initial treatment of patients with severe trauma as it is not useful in ICP monitoring or checking patient’s level of consciousness.
참고문헌 (14)
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