Prognostic Role of Optic Nerve Sheath Diameter for Neurological Outcomes in Post-Cardiac Arrest Patients: A Systematic Review and Meta-Analysis

Abstract

Objective. The present study investigated whether optic nerve sheath diameter (ONSD) could be used to predict neurological outcomes in post-cardiac arrest (CA) patients. Methods. We performed a comprehensive literature search in the Cochrane Library, ScienceDirect, PubMed, and Web of Science from inception to June 2020 for eligible articles. Stata 14.0 software was used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs), sensitivity, specificity, summary receiver operating characteristic (SROC) curve, subgroup analysis, sensitivity analysis, and publication bias. Results. Eight studies involving 473 patients were considered eligible for this meta-analysis. The pooled result using a random-effects model showed that broadened ONSD is associated with poor neurological outcomes in post-CA patients (OR=15.62, 95% CI: 5.50-44.34, P<0.001; I2=58.4%, P=0.018), with a sensibility of 0.60 (95% CI: 0.45-0.73) and specificity of 0.94 (95% CI: 0.83-0.98). The area under the curve of the SROC curve for ONSD was 0.87 (95% CI: 0.84-0.90). Subgroup analysis revealed that sample size and time of ONSD measurement may be the source of heterogeneity. Sensitivity analysis demonstrated the stability of the results of this meta-analysis. No publication bias using Deeks' funnel plot was noted across the studies (P=0.23). Conclusion. This meta-analysis confirmed that ONSD can be used to predict neurological outcomes in post-CA patients.