Prognostic Value of Optic Nerve Sheath Diameter in Critically Ill Patients

Background: The relationship between optic nerve sheath diameter (ONSD) and mortality outcomes in critically ill intensive care unit (ICU) patients is an area of increasing interest. This study aimed to explore whether ONSD can serve as a reliable predictor of mortality in ICU patients, potentially offering a noninvasive tool to guide clinical decision-making and patient management. Materials and Methods: This prospective cohort study included critically ill ICU patients aged 14 years and above, excluding those with preexisting optic nerve disorders, traumatic brain injury, or intracerebral hemorrhage. Demographic and clinical data, including age, sex, comorbidities, injury severity score, Glasgow Coma Scale, and laboratory data, such as liver function tests, hemoglobin (Hb) level, and procalcitonin level, were collected. ONSD was measured on Day 0 and Day 7 using transorbital ultrasonography. Statistical analysis was performed using SPSS version 21 to determine the association between ICU mortality and other outcomes. Results: The patients in this study had a mean age of 58.29 years, with the majority presenting with comorbidities such as diabetes mellitus and hypertension. Clinical outcomes showed significant reductions in Hb, C-reactive protein, and urea levels over 10 days, with a notable prevalence of sepsis (91.2%) and a survival rate of 66.2%, whereas the ONSD scores varied between survivors and nonsurvivors. Conclusion: ONSD measurement is a valuable prognostic tool in ICU patients, correlating with mortality outcomes, especially in those with elevated intracranial pressure, and can help guide timely interventions for better outcomes.