Investigation of the effectiviness of optic nerve sheath diameter measurements on morbidity and mortality in patients with intracranial pathologies treated in the intensive care unit

In our study, we investigated the effects of optic nerve sheath diameter measurements on morbidity and mortality in patients with intracranial pathology treated in the intensive care unit; we aimed to determine the prediction of survival for intensive care patients. 197 patients who applied to the Anesthesiology and Reanimation Intensive Care Clinic of Trakya University Faculty of Medicine between June 2021 and January 2025 and met the criteria were included in the study. Orbital USG was performed on the patients and ONSD was measured. ONSD measurements were made on the day the patient was admitted to the intensive care unit, on the 3rd day and on the 7th day. During the follow-up of the patients, ABG results and hemodynamic data were recorded from the data in the files. The duration of intensive care unit stay, mechanical ventilation duration and prognosis of all patients were recorded. The patients were followed up until they were discharged from the intensive care unit or died. All patients who were discharged from the intensive care unit with recovery were followed up for 6 months using the SPS scale and GOS score, and the relationship between ONSD measurement and neurological status was investigated. ROC analysis was performed for efficacy evaluation. The mean age of the patients included in the study was 58 ±13. According to the findings of the study, the mortality rate was significantly higher in patients with high ONSD values. 53 Especially ONSD measurements over 5.9 mm predicted 6-month mortality with high sensitivity and specificity (AUC = 0.92, p < 0.001). In addition, it was determined that ONSD was directly related to mortality in specific pathologies such as TBI and SAH and that this measurement could be an important indicator in early prognosis prediction. When evaluated together with parameters such as blood gas analyses (pH, PaCO2) and length of stay in intensive care, it was concluded that ONSD could be used as a non-invasive prognostic marker. Thanks to our study, ONSD was measured in patients with a wider disease spectrum and a significant relationship was shown between ONSD and their survival. The validity and reliability of these measurements have been supported, they have been found to be useful, and cut-off values have been determined. Keywords: Optic Nerve Sheath Diameter, TBI, GKS, APACHE, SOFA, GOS, Intensive Care