Predictive value of optical nerve sheath diameter to Eyeball Transverse Diameter ratio on mortality of head trauma

G. Karamise, O.A. Oruc

Department of Emergency Medicine, Health Ministry, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey. droyaoruc@gmail.com

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• Traumatology

OBJECTIVE: Optic nerve sheath diameter (ONSD) and Eyeball Transverse Diameter (ETD) can be measured to determine cranial pressure due to intracranial injury. The study aimed to measure the diagnostic potential of ONSD and ETD to predict mortality in head traumas.

PATIENTS AND METHODS: This cross-sectional study included 483 patients who applied to the emergency department with head trauma and analyzed characteristics, Rotterdam Computed Tomography Score (RCTS), Glasgow Coma Score (GCS), ETD, and ONSD. ONSD was calculated from 3 mm proximal to the optic disc in the section by tomography and manually divided to ETD to generate ONSD/ETD (Index).

RESULTS: GCS, RCTS, ONSD (right: R; left: L), and Index (right: R; left: L) indicated a significant difference between mortal and non-mortal trauma (p < 0.001). In ROC analysis of the mortality prediction for the ONSD-R, the sensitivity and the specificity were 83.3% and 57.1% (p = 0.001), while those were 91.7% and 68.2% for ONSD-L (p = 0.0001). In Index-R, the sensitivity and specificity were 74% and 84.5% (p = 0.0001), while those were 75.2% and 85% for Index-L (p = 0.0001).

CONCLUSIONS: The index, which can be measured easily by the proportion of ONSD and ETD at admissions to Emergency Departments by CT, can provide crucial information to physicians in predicting the mortality of patients with head trauma.

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