{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:53:48Z","timestamp":1789624428925,"version":"build-2803163510"},"reference-count":26,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: The optic nerve sheath diameter (ONSD) is indicative of elevated intracranial pressure. However, the usefulness of the ONSD for predicting neurologic outcomes in cardiac arrest survivals has been debatable. Reportedly, the ONSD\/eyeball transverse diameter (ETD) ratio is a more reliable marker for identifying intracranial pressure than sole use of ONSD. Materials and Methods: This retrospective study aimed to investigate the prognostic value of the ONSD\/ETD ratio in out-of-hospital cardiac arrest (OHCA) patients. We studied the brain computed tomography scans of adult OHCA patients with return of spontaneous circulation, who visited a single hospital connected with a Korean university between January 2015 and September 2020. We collected baseline characteristics and patient information from electronic medical records and ONSD and ETD were measured by two physicians with a pre-defined protocol. According to their neurologic outcome upon hospital discharge, patients were divided into good neurologic outcome (GNO; cerebral performance category [CPC] 1\u20132) and poor neurologic outcome (PNO; CPC 3\u20135) groups. We evaluated the ONSD\/ETD ratio between the GNO and PNO groups to establish its prognostic value for neurologic outcomes. Results: Of the 100 included patients, 28 had GNO. Both the ONSD and ETD were not significantly different between the two groups (ONSD, 5.48 mm vs. 5.66 mm, p = 0.054; ETD, 22.98 mm vs. 22.61 mm, p = 0.204). However, the ONSD\/ETD ratio was significantly higher in the PNO group in the univariate analysis (0.239 vs. 0.255, p = 0.014). The area under the receiver operating characteristic curve of ONSD\/ETD ratio for predicting PNO was 0.66 (95% confidence interval, 0.56\u20130.75; p = 0.006). There was no independent relationship between the ONSD\/ETD ratio and PNO in multivariate analysis (aOR = 0.000; p = 0.173). Conclusions: The ONSD\/ETD ratio was more reliable than sole use of ONSD and might be used to predict neurologic outcomes in OHCA survivors.<\/jats:p>","DOI":"10.3390\/medicina58091233","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T22:33:01Z","timestamp":1662503581000},"page":"1233","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Prognostic Value of Optic Nerve Sheath Diameter\/Eyeball Transverse Diameter Ratio in the Neurological Outcomes of Out-of-Hospital Cardiac Arrest Patients"],"prefix":"10.3390","volume":"58","author":[{"given":"Byeong-In","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Hanyang University College of Medicine, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5700-3331","authenticated-orcid":false,"given":"Heekyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Hanyang University College of Medicine, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3203-1672","authenticated-orcid":false,"given":"Hyungoo","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Hanyang University College of Medicine, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changsun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Hanyang University College of Medicine, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5458-5919","authenticated-orcid":false,"given":"Hyuk-Joong","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Hanyang University College of Medicine, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Seoung","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Hanyang University College of Medicine, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1007\/BF01720676","article-title":"Prognostic Significance of Early Intracranial and Cerebral Perfusion Pressures in Post-Cardiac Arrest Anoxic Coma","volume":"17","author":"Gueugniaud","year":"1991","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","article-title":"Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"142","author":"Panchal","year":"2020","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.resuscitation.2016.04.001","article-title":"Better Prognostic Value with Combined Optic Nerve Sheath Diameter and Grey-to-White Matter Ratio on Initial Brain Computed Tomography in Post-Cardiac Arrest Patients","volume":"104","author":"Chae","year":"2016","journal-title":"Resuscitation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.resuscitation.2019.07.004","article-title":"Optimal Timing to Measure Optic Nerve Sheath Diameter as a Prognostic Predictor in Post-Cardiac Arrest Patients Treated with Targeted Temperature Management","volume":"143","author":"Park","year":"2019","journal-title":"Resuscitation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.resuscitation.2019.10.004","article-title":"Relationship between Optic Nerve Sheath Diameter Measured by Magnetic Resonance Imaging, Intracranial Pressure, and Neurological Outcome in Cardiac Arrest Survivors Who Underwent Targeted Temperature Management","volume":"145","author":"Kang","year":"2019","journal-title":"Resuscitation"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kim, J.-G., Kim, W., Shin, H., Lim, T.-H., Jang, B.-H., Cho, Y., Choi, K.-S., Na, M.-K., Ahn, C., and Lee, J. 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