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Optimal optic nerve sheath diameter threshold for the identification of elevated opening pressure on lumbar puncture in a Chinese population.

Wang L, Feng L, Yao Y, Wang Y, Chen Y, Feng J, Xing Y - PLoS ONE (2015)

Bottom Line: ONSD was a significant independent predictor of elevated opening pressure on LP (p<0.001).The cut-off point of this predictor in a Chinese population was remarkably lower than that found in a Caucasian population.Thus, ethnic differences should be noted when using the ONSD as an indicator of increased ICP.

View Article: PubMed Central - PubMed

Affiliation: The Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, China.

ABSTRACT
Ultrasonography of the optic nerve sheath diameter (ONSD) is a non-invasive and rapid method that might be helpful in the identification of increased intracranial pressure (ICP). The use of an ONSD greater than 5 mm on ultrasound as an indicator of increased ICP in a Caucasian population has been studied. However, the cut-off point of this predictor in Chinese patients has not been established. Thus, we conducted this study to identify the ONSD criterion for the detection of elevated opening pressure on lumbar puncture (LP) in a Chinese population and to investigate the influencing factors. This study was a blind cross-sectional study. Patients who presented with suspected increased ICP were included. The opening pressure on LP of each participant was confirmed. We analyzed the clinical differences between the groups of patients with abnormal and normal opening pressures on LP. A receiver operating characteristic curve was constructed to determine the ONSD cut-off point for the identification of abnormal opening pressure on LP. In total, 279 patients were recruited, and 101 patients presented with elevated opening pressure on LP. ONSD was a significant independent predictor of elevated opening pressure on LP (p<0.001). However, no statistical significance was observed regarding the factors that might have affected this relationship including gender, age, body mass index, waistline, head circumference, hypertension and pathological subtype. The ONSD cut-off point for the identification of elevated opening pressure on LP was 4.1 mm; this cut-off yielded a sensitivity of 95% and a specificity of 92%. ONSD is a strong and accurate predictor of elevated opening pressure on LP. The cut-off point of this predictor in a Chinese population was remarkably lower than that found in a Caucasian population. Thus, ethnic differences should be noted when using the ONSD as an indicator of increased ICP.

No MeSH data available.


Related in: MedlinePlus

ROC curve for the optic nerve sheath diameter.AUC = 0.965 (95% CI: 0.947–0.984).
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pone.0117939.g002: ROC curve for the optic nerve sheath diameter.AUC = 0.965 (95% CI: 0.947–0.984).

Mentions: Using the opening pressure on LP as the standard criterion, we generated a ROC curve (Fig. 2) to determine the cut-off point that optimized the sensitivity and specificity. The ROC curve analysis revealed that the area under the curve (AUC) was 0.965 (95% CI: 0.947–0.984). The ONSD cut-off point for the identification of elevated opening pressure on LP was 4.1 mm, which yielded a sensitivity of 95% and a specificity of 92%.


Optimal optic nerve sheath diameter threshold for the identification of elevated opening pressure on lumbar puncture in a Chinese population.

Wang L, Feng L, Yao Y, Wang Y, Chen Y, Feng J, Xing Y - PLoS ONE (2015)

ROC curve for the optic nerve sheath diameter.AUC = 0.965 (95% CI: 0.947–0.984).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4322040&req=5

pone.0117939.g002: ROC curve for the optic nerve sheath diameter.AUC = 0.965 (95% CI: 0.947–0.984).
Mentions: Using the opening pressure on LP as the standard criterion, we generated a ROC curve (Fig. 2) to determine the cut-off point that optimized the sensitivity and specificity. The ROC curve analysis revealed that the area under the curve (AUC) was 0.965 (95% CI: 0.947–0.984). The ONSD cut-off point for the identification of elevated opening pressure on LP was 4.1 mm, which yielded a sensitivity of 95% and a specificity of 92%.

Bottom Line: ONSD was a significant independent predictor of elevated opening pressure on LP (p<0.001).The cut-off point of this predictor in a Chinese population was remarkably lower than that found in a Caucasian population.Thus, ethnic differences should be noted when using the ONSD as an indicator of increased ICP.

View Article: PubMed Central - PubMed

Affiliation: The Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, China.

ABSTRACT
Ultrasonography of the optic nerve sheath diameter (ONSD) is a non-invasive and rapid method that might be helpful in the identification of increased intracranial pressure (ICP). The use of an ONSD greater than 5 mm on ultrasound as an indicator of increased ICP in a Caucasian population has been studied. However, the cut-off point of this predictor in Chinese patients has not been established. Thus, we conducted this study to identify the ONSD criterion for the detection of elevated opening pressure on lumbar puncture (LP) in a Chinese population and to investigate the influencing factors. This study was a blind cross-sectional study. Patients who presented with suspected increased ICP were included. The opening pressure on LP of each participant was confirmed. We analyzed the clinical differences between the groups of patients with abnormal and normal opening pressures on LP. A receiver operating characteristic curve was constructed to determine the ONSD cut-off point for the identification of abnormal opening pressure on LP. In total, 279 patients were recruited, and 101 patients presented with elevated opening pressure on LP. ONSD was a significant independent predictor of elevated opening pressure on LP (p<0.001). However, no statistical significance was observed regarding the factors that might have affected this relationship including gender, age, body mass index, waistline, head circumference, hypertension and pathological subtype. The ONSD cut-off point for the identification of elevated opening pressure on LP was 4.1 mm; this cut-off yielded a sensitivity of 95% and a specificity of 92%. ONSD is a strong and accurate predictor of elevated opening pressure on LP. The cut-off point of this predictor in a Chinese population was remarkably lower than that found in a Caucasian population. Thus, ethnic differences should be noted when using the ONSD as an indicator of increased ICP.

No MeSH data available.


Related in: MedlinePlus