Diagnostic accuracy of optic nerve sheath diameter on ultrasound for the detection of increased intracranial pressure in patients with traumatic brain injury: A systematic review and meta‑analysis

Chen,Weiting; Zhang,Xia; Ye,Xiuxiu; Ying,Pan

doi:10.3892/br.2023.1685

Diagnostic accuracy of optic nerve sheath diameter on ultrasound for the detection of increased intracranial pressure in patients with traumatic brain injury: A systematic review and meta‑analysis

Authors:
- Weiting Chen
- Xia Zhang
- Xiuxiu Ye
- Pan Ying
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Affiliations: Department of Emergency and Intensive Care Unit, The First People's Hospital of Linhai, Taizhou, Zhejiang 317000, P.R. China, Department of Emergency, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, P.R. China
Published online on: October 30, 2023 https://doi.org/10.3892/br.2023.1685
Article Number: 103
Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The timely diagnosis and treatment of elevated intracranial pressure (ICP) reduces morbidity rates and prevents mortality. The aim of the present systematic review and meta‑analysis was to determine the diagnostic accuracy of optic nerve sheath diameter (ONSD) vs. standard invasive ICP measurements in patients with traumatic brain injury (TBI). The PubMed, Embase, Web of Science and Cochrane Library databases were systematically searched for studies including adult patients with TBI with suspected elevated ICP, and the sonographic ONSD measurements were compared with those from a standard invasive method. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies‑2 tool by two independent authors. A bivariate random effects model was used to summarize the pooled sensitivity, specificity and diagnostic odds ratio (DOR). A total of eight prospective studies with 222 patients with TBI were included. The pooled sensitivity was 0.82 [95% confidence interval (CI), 0.75‑0.88], the specificity was 0.82 (95% CI, 0.71‑0.90) and the DOR was 17.75 (95% CI, 7.02‑44.83) with partial evidence of heterogeneity. The accuracy of the area under the summary ROC was 0.87. An ultrasound‑determined elevated ICP has reasonable performance indicators with high sensitivity and specificity in patients with TBI. As such, this method may be a useful complementary monitoring tool in acute care.

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