Prognostic performance of optic nerve sheath diameters in CT images and serum procalcitonin levels in traumatic brain injury patients in the intensive care unit: A retrospective cohort study
Abstract
Aim: Traumatic brain injury (TBI) is one of the common emergencies with a high mortality rate. It is difficult to determine the mortality and prognosis of TBI in the intensive care unit (ICU). The aim of this study is to assess the prognostic relationship of optic nerve sheath diameters (ONSD) as seen on computerized tomography (CT) images as well as serum procalcitonin (PCT) levels to mortality and Glasgow Outcome Scale (GOS) scores of patients with traumatic brain injury in the ICU.
Methods: Data from 78 traumatic brain injury patients who were admitted to an ICU, underwent brain CT and had serum PCT levels measured, were investigated retrospectively. Patients’ data were gathered from ICU medical records. The ONSD was measured at 3 mm behind the globe.
Results: The mean age of the patients was 57.11 (17.07) years. 57.7% of the patients were males, and 42.3% were females. The cut-off ONSD and serum PCT values were evaluated to determine mortality and prognosis (Cut-off values: right ONSD: 5.44, left ONSD: 5.37, PCT: 3.95 for mortality; right ONSD: 5.26, left ONSD: 5.28, PCT: 2.29 for GOS, respectively).
Conclusion: ONSD measurements and serum PCT levels are associated with mortality and prognosis in traumatic brain injury patients.
References
- 1. Prabhakaran K, Petrone P, Lombardo G, Stoller C, Policastro A, Marini CP. Mortality rates of severe traumatic brain injury patients: impact of direct versus nondirect transfers. J Surg Res. 2017;219:66–71. doi: 10.1016/j.jss.2017.05.103
- 2. Waheed S, Baig MA, Siddiqui E, Jamil D, Bashar M, Feroze A. Prognostic significance of optic nerve sheath diameter on computed tomography scan with severity of blunt traumatic brain injury in the emergency department. J Pak Med Assoc. 2018;68:268–71.
- 3. Carney N, Totten AM, OʼReilly C, Ullman JS, Hawryluk GW,Bell MJ ,et al.Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery. 2017;80:6-15. doi: 10.1227/NEU.0000000000001432
- 4. Lee SH, Yun SJ. Optic nerve sheath diameter on facial CT: a tool to predict traumatic brain injury. Eur J Trauma Emerg Surg. 2018 Oct 15. doi: 10.1007/s00068-018-1035-310.1007/s00068-018-1035-3
- 5. Sauerland S, Hensler T, Bouillon B, Rixen D, Raum MR, Andermahr J et al. Plasma levels of procalcitonin and neopterin in multiple trauma patients with or without brain injury. J Neurotrauma. 2003;20:953–60. doi: 10.1089/089771503770195803
- 6. Legrand A, Jeanjean P, Delanghe F, Peltier J, Lecat B, Dupont H. Estimation of optic nerve sheath diameter on an initial brain computed tomography scan can contribute prognostic information in traumatic brain injury patients. Crit Care. 2013;17:R61. 10.1186/cc12589
- 7. Ok G, Aydin D, Erbüyün K, Gürsoy C, Taneli F, Bilge S, et al. Neurological outcome after cardiac arrest: a prospective study of the predictive ability of prognostic biomarkers neuron-specific enolase, glial fibrillary acidic protein, S-100B, and procalcitonin. Turkish J Med Sci. 2016; 46:1459–68. doi: 10.3906/sag-1503-64
Yoğun bakım ünitesinde travmatik beyin hasarlı hastalarda BT görüntülerinden elde edilen optik sinir kılıf çapı ve serum prokalsitonin değerlerinin prognostik performansları: Retrospektif kohort çalışma
Abstract
Amaç: Travmatik beyin hasarı (TBH) yüksek mortalite oranı ile sonuçlanan sık karşılaşılan acillerden biridir. Yoğun bakım ünitesinde (YBÜ) TBH için mortalite ve prognozu belirlemek zorudur. Bu çalışmanın amacı, YBÜ’deki travmatik beyin hasarı olguların mortalite ve Glasgow outcome skalası ile bilgisayarlı tomografi (BT) görüntülerinden elde edilen optik sinir kılıf çapı ve serum prokalsitonin seviyeleri arasındaki ilişkiyi göstermek ve optik sinir kılıf çapıyla prokalsitonin seviyesinin prognostik değerini ölçmektir.
Yöntemler: Beyin BT görüntülemesi yapılmış ve serum prokalsitonin düzeyi çalışılmış 78 travmatik beyin hasarı hastasının verileri retrospektif olarak incelendi. Hasta verileri yoğun bakım tıbbi kayıtlarından elde edildi. Optik sinir kılıf çapı göz güresinin 3 mm arkasından ölçüldü.
Bulgular: Hastaların yaş ortalaması 57,11 (17,07) iken %57,7’si erkek, %42,3’ü kadındı. Optik sinir kılıf çapı ve serum prokalsitonin cut-off değerleri, mortalite ve prognozu belirlemek için hesaplandı. Mortalite için cut-off değerleri sırasıyla: Sağ ONSD: 5,44, sol ONSD: 5,37, PCT: 3,95, GOS için sağ ONSD: 5,26, sol ONSD: 5,28, PCT: 2,29’du.
Sonuç: Optik sinir kılıf çapı ölçümü ve prokalsitonin seviyeleri travmatik beyin hasarlı hastalarda mortalite ve prognoz ile ilişkilidir.
References
- 1. Prabhakaran K, Petrone P, Lombardo G, Stoller C, Policastro A, Marini CP. Mortality rates of severe traumatic brain injury patients: impact of direct versus nondirect transfers. J Surg Res. 2017;219:66–71. doi: 10.1016/j.jss.2017.05.103
- 2. Waheed S, Baig MA, Siddiqui E, Jamil D, Bashar M, Feroze A. Prognostic significance of optic nerve sheath diameter on computed tomography scan with severity of blunt traumatic brain injury in the emergency department. J Pak Med Assoc. 2018;68:268–71.
- 3. Carney N, Totten AM, OʼReilly C, Ullman JS, Hawryluk GW,Bell MJ ,et al.Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery. 2017;80:6-15. doi: 10.1227/NEU.0000000000001432
- 4. Lee SH, Yun SJ. Optic nerve sheath diameter on facial CT: a tool to predict traumatic brain injury. Eur J Trauma Emerg Surg. 2018 Oct 15. doi: 10.1007/s00068-018-1035-310.1007/s00068-018-1035-3
- 5. Sauerland S, Hensler T, Bouillon B, Rixen D, Raum MR, Andermahr J et al. Plasma levels of procalcitonin and neopterin in multiple trauma patients with or without brain injury. J Neurotrauma. 2003;20:953–60. doi: 10.1089/089771503770195803
- 6. Legrand A, Jeanjean P, Delanghe F, Peltier J, Lecat B, Dupont H. Estimation of optic nerve sheath diameter on an initial brain computed tomography scan can contribute prognostic information in traumatic brain injury patients. Crit Care. 2013;17:R61. 10.1186/cc12589
- 7. Ok G, Aydin D, Erbüyün K, Gürsoy C, Taneli F, Bilge S, et al. Neurological outcome after cardiac arrest: a prospective study of the predictive ability of prognostic biomarkers neuron-specific enolase, glial fibrillary acidic protein, S-100B, and procalcitonin. Turkish J Med Sci. 2016; 46:1459–68. doi: 10.3906/sag-1503-64
Details
| Primary Language | English |
|---|---|
| Subjects | Intensive Care |
| Journal Section | Research article |
| Authors | |
| Publication Date | September 1, 2019 |
| Published in Issue | Year 2019 Volume: 3 Issue: 9 |
