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Original Research

Open Access Special Issue

Optic nerve sheath diameter as a predictor of altered mental status in drug intoxication patients

  • Keon Kim1
  • Seong Jin Bae2
  • Seong Jong Yun3
  • Sun Hwa Lee4

1Department of Emergency Medicine, Ewha Womans University, Seoul Hospital, 07804 Seoul, Republic of Korea

2Department of Emergency Medicine, Chung-Ang University Hospital, 06973 Seoul, Republic of Korea

3Department of Radiology, G SAM Hospital, 15839 Gyeonggi, Republic of Korea

4Department of Emergency Medicine, Ewha Womans University, Mok-Dong Hospital, 07985 Seoul, Republic of Korea

DOI: 10.22514/sv.2021.064 Vol.17,Issue 4,July 2021 pp.71-78

Submitted: 30 January 2021 Accepted: 04 March 2021

Published: 08 July 2021

*Corresponding Author(s): Sun Hwa Lee E-mail:


Objectives: As far as we know, proposed the predictive performance of optic nerve sheath diameter measured (ONSD) from brain computed tomography to predict poor prognosis in drug intoxication patients. The aim of our study was to evaluate the predictive performance of ONSD for predicting mortality and admission in patients with altered mental status among drug intoxication patients.

Method: We retrospectively enrolled patients with drug intoxication patients who underwent brain computed tomography due to altered mental status between January 2018 and December 2019.

Two emergency physicians independently measured ONSD at 3 mm behind the globe in each patients. Statistical analysis including multivariate logistic regression analysis were yielded to estimate predictive performance.

Results: A total of 18 patients (8.7%) were death and 57 patients (24%) were admitted out of 206 patients. ONSD was independently predictive factors for predicting mortality and admission. ONSD (cut-off = 4.35) had 69.05% sensitivity and 53.33% specificity with area under the receiver operating characteristic curve of 0.824 (95% CI = 0.803–0.927) for predicting mortality among drug intoxication patients while the ONSD (cut-off = 3.96) had 100% sensitivity and 51.5% specificity with area under the receiver operating characteristic curve of 0.824 (95% CI, 0.722–0.927) for predicting admission among patients. There were excellent inter- and intra-observer agreements for measuring ONSD on brain CT.

Conclusion: ONSD was demonstrated as feasible predictive marker for predicting admission and mortality among drug intoxication patients with altered mental status. This information can help decision making for emergency physicians to provide prompt treatment in drug intoxication patients.


Drug overdose; Computed tomograhy; Mortality; Outcome; Prognostic marker

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Keon Kim,Seong Jin Bae,Seong Jong Yun,Sun Hwa Lee. Optic nerve sheath diameter as a predictor of altered mental status in drug intoxication patients. Signa Vitae. 2021. 17(4);71-78.


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