Ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarction
Abstract Large hemispheric infarction (LHI) is a severe form of stroke with high mortality and poor outcomes. Ultrasonic optic nerve sheath diameter (ONSD) is considered an effective indicator for intracranial hypertension. Our study aimed to validate the efficiency of ultrasonic ONSD and develop a...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-024-84720-6 |
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| author | Jie Zhang Shimeng Zhuang Ying Zhang Lisi An Dongyang Li Zhen Liu Lijuan Wang |
| author_facet | Jie Zhang Shimeng Zhuang Ying Zhang Lisi An Dongyang Li Zhen Liu Lijuan Wang |
| author_sort | Jie Zhang |
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| description | Abstract Large hemispheric infarction (LHI) is a severe form of stroke with high mortality and poor outcomes. Ultrasonic optic nerve sheath diameter (ONSD) is considered an effective indicator for intracranial hypertension. Our study aimed to validate the efficiency of ultrasonic ONSD and develop a nomogram to identify LHI patients who have 90-day mortality. We recruited 419 LHI patients (training cohort, n = 202; internal validation cohort, n = 86; and external validation cohort, n = 131) from six centers. Demographic, laboratory, computed tomography, and ultrasonic data were collected. At 90 days, 41.8% of patients died. Ultrasonic ONSD (odds ratio [OR], 7.026; 95% CI, 2.638–18.708; P < 0.001), male (OR, 8.620; 95% CI, 2.962–25.092; P < 0.001), midline shift (OR, 1.207; 95% CI, 1.085–1.342; P = 0.001), and infarction volume (OR, 1.020; 95% CI, 1.012–1.028; P < 0.001) were independent predictors. In identifying LHI patients prone to 90-day mortality, the nomogram developed using these predictors showed areas under the receiver operating characteristic curve (AUC) of 0.897, 0.824, 0.833 in the training cohort, internal and external validation cohorts, respectively. Ultrasonic ONSD complement the midline shift and infarction volume to create a reliable multimodal method for monitoring prognosis in patients with LHI. |
| format | Article |
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| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-241e87564e21484496d8ee4cbda8fe882025-01-05T12:18:53ZengNature PortfolioScientific Reports2045-23222025-01-011511810.1038/s41598-024-84720-6Ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarctionJie Zhang0Shimeng Zhuang1Ying Zhang2Lisi An3Dongyang Li4Zhen Liu5Lijuan Wang6Neuroscience Center, Department of Neurology, First Hospital of Jilin University, Jilin UniversityDepartment of Ultrasonography, Siping Central People’s HospitalDepartment of Ultrasonography, Meihekou Central HospitalDepartment of Functional Examination Section, Jilin Electric Power HospitalDepartment of Vascular Ultrasonography, Dehui People’s HospitalDepartment of Ultrasonography, Bayannur Linhe District People’s HospitalNeuroscience Center, Department of Neurology, First Hospital of Jilin University, Jilin UniversityAbstract Large hemispheric infarction (LHI) is a severe form of stroke with high mortality and poor outcomes. Ultrasonic optic nerve sheath diameter (ONSD) is considered an effective indicator for intracranial hypertension. Our study aimed to validate the efficiency of ultrasonic ONSD and develop a nomogram to identify LHI patients who have 90-day mortality. We recruited 419 LHI patients (training cohort, n = 202; internal validation cohort, n = 86; and external validation cohort, n = 131) from six centers. Demographic, laboratory, computed tomography, and ultrasonic data were collected. At 90 days, 41.8% of patients died. Ultrasonic ONSD (odds ratio [OR], 7.026; 95% CI, 2.638–18.708; P < 0.001), male (OR, 8.620; 95% CI, 2.962–25.092; P < 0.001), midline shift (OR, 1.207; 95% CI, 1.085–1.342; P = 0.001), and infarction volume (OR, 1.020; 95% CI, 1.012–1.028; P < 0.001) were independent predictors. In identifying LHI patients prone to 90-day mortality, the nomogram developed using these predictors showed areas under the receiver operating characteristic curve (AUC) of 0.897, 0.824, 0.833 in the training cohort, internal and external validation cohorts, respectively. Ultrasonic ONSD complement the midline shift and infarction volume to create a reliable multimodal method for monitoring prognosis in patients with LHI.https://doi.org/10.1038/s41598-024-84720-6Large hemispheric infarctionMortalityOptic nerve sheath diameterUltrasound |
| spellingShingle | Jie Zhang Shimeng Zhuang Ying Zhang Lisi An Dongyang Li Zhen Liu Lijuan Wang Ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarction Scientific Reports Large hemispheric infarction Mortality Optic nerve sheath diameter Ultrasound |
| title | Ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarction |
| title_full | Ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarction |
| title_fullStr | Ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarction |
| title_full_unstemmed | Ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarction |
| title_short | Ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarction |
| title_sort | ultrasonic optic nerve sheath diameter as a new predictor for the mortality of patients with large hemispheric infarction |
| topic | Large hemispheric infarction Mortality Optic nerve sheath diameter Ultrasound |
| url | https://doi.org/10.1038/s41598-024-84720-6 |
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