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Effects of Age and Sex on Optic Nerve Sheath Diameter in Healthy Volunteers and Patients With Traumatic Brain Injury.
Frontiers in Neurology ( IF 2.7 ) Pub Date : 2020-08-07 , DOI: 10.3389/fneur.2020.00764
Danilo Cardim 1, 2, 3 , Marek Czosnyka 1, 4 , Karthikka Chandrapatham 5 , Rafael Badenes 6 , Alessandro Bertuccio 7 , Anna Di Noto 8 , Joseph Donnelly 1, 9 , Paolo Pelosi 5, 8 , Lorenzo Ball 5, 8 , Peter J Hutchinson 10 , Chiara Robba 1, 8
Affiliation  

The measurement of optic nerve sheath diameter (ONSD) has been reported as a non-invasive marker for intracranial pressure (ICP). Nevertheless, it is uncertain whether possible ONSD differences occur with age and sex in healthy and brain-injured populations. The aim of this study was to investigate the effects of sex and age on ONSD in healthy volunteers and patients with traumatic brain injury. We prospectively included 122 healthy adult volunteers (Galliera Hospital, Genova, Italy), and compared age/sex dependence of ONSD to 95 adult patients (Addenbrooke's Hospital, Cambridge, UK) with severe traumatic brain injury (TBI) requiring intubation and invasive ICP monitoring. The two groups were stratified for sex and age. Age was divided into 3 subgroups: (1) young adults: 18-44 years; (2) middle-aged adults: 45-64 years; (3) old adults: >65 years. In healthy volunteers, ONSD was significantly different between males and females [median (interquartile range): 4.2 (3.9-4.6) mm vs. 4.1 (3.6-4.2) mm (p = 0.01), respectively] and was correlated with age (R = 0.50, p < 0.0001). ONSD was significantly increased in group 3 compared to groups 2 and 1, indicating that ONSD values are higher in elderly subjects. In TBI patients, no differences in ONSD were found for sex and the correlation between ONSD and age was non-significant (R = 0.13, p = 0.20). ONSD increases with age and is significantly larger for males in healthy volunteers but not in TBI patients. Different ONSD cut-off values need not be age- or sex-adjusted for the assessment of increased ICP in TBI patients.

中文翻译:

年龄和性别对健康志愿者和颅脑外伤患者视神经鞘管直径的影响。

视神经鞘管直径(ONSD)的测量已报道为颅内压(ICP)的非侵入性标记。然而,尚不确定健康和脑损伤人群中是否存在随年龄和性别发生的ONSD差异。这项研究的目的是调查健康志愿者和脑外伤患者的性别和年龄对ONSD的影响。我们前瞻性地纳入了122名健康的成人志愿者(意大利热那亚的加利利拉医院),并将ONSD的年龄/性别依赖性与需要插管和有创ICP监测的95名严重脑外伤(TBI)的成年患者(英国剑桥的Addenbrooke医院)进行了比较。两组按性别和年龄分类。年龄分为3个亚组:(1)年轻人:18-44岁;(2)中年成年人:45-64岁;(3)老年人:> 65岁 在健康志愿者中,男女的ONSD显着不同[中位数(四分位间距):分别为4.2(3.9-4.6)毫米和4.1(3.6-4.2)毫米(p = 0.01)],并且与年龄相关(R = 0.50,p <0.0001)。与第2组和第1组相比,第3组的ONSD显着增加,表明老年受试者的ONSD值较高。在TBI患者中,性别上的ONSD没有差异,并且ONSD和年龄之间的相关性不显着(R = 0.13,p = 0.20)。在健康志愿者中,ONSD随着年龄的增长而增加,男性明显更大,而在TBI患者中则没有。为评估TBI患者的ICP升高,无需对年龄进行不同的ONSD截止值或性别调整。分别为4.2(3.9-4.6)毫米和4.1(3.6-4.2)毫米(p = 0.01)],并且与年龄相关(R = 0.50,p <0.0001)。与第2组和第1组相比,第3组的ONSD显着增加,表明老年受试者的ONSD值较高。在TBI患者中,性别上的ONSD没有差异,并且ONSD和年龄之间的相关性不显着(R = 0.13,p = 0.20)。在健康志愿者中,ONSD随着年龄的增长而增加,男性明显更大,而在TBI患者中则没有。为评估TBI患者的ICP升高,无需对年龄进行不同的ONSD截止值或性别调整。分别为4.2(3.9-4.6)毫米和4.1(3.6-4.2)毫米(p = 0.01)],并且与年龄相关(R = 0.50,p <0.0001)。与第2组和第1组相比,第3组的ONSD显着增加,表明老年受试者的ONSD值较高。在TBI患者中,性别上的ONSD没有差异,并且ONSD和年龄之间的相关性不显着(R = 0.13,p = 0.20)。在健康志愿者中,ONSD随着年龄的增长而增加,男性明显更大,而在TBI患者中则没有。为评估TBI患者的ICP升高,无需对年龄进行不同的ONSD截止值或性别调整。表明老年人的ONSD值较高。在TBI患者中,性别上的ONSD没有差异,并且ONSD和年龄之间的相关性不显着(R = 0.13,p = 0.20)。在健康志愿者中,ONSD随着年龄的增长而增加,男性明显更大,而在TBI患者中则没有。为评估TBI患者的ICP升高,无需对年龄进行不同的ONSD截止值或性别调整。表明老年人的ONSD值较高。在TBI患者中,性别上的ONSD没有差异,并且ONSD和年龄之间的相关性不显着(R = 0.13,p = 0.20)。在健康志愿者中,ONSD随着年龄的增长而增加,男性明显更大,而在TBI患者中则没有。为评估TBI患者的ICP升高,无需对年龄进行不同的ONSD截止值或性别调整。
更新日期:2020-08-07
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