视神经鞘直径预测心搏骤停患者预后的meta分析

杜雨森; 王文杰; 冯顺易; 李勇

doi:10.13201/j.issn.1009-5918.2020.10.012

视神经鞘直径预测心搏骤停患者预后的meta分析

- 沧州市中心医院急诊医学部(河北沧州, 061000)

详细信息

通讯作者: 李勇,E-mail:ly13333367871@hotmail.com

中图分类号: R459.7；R595.4

收稿日期: 2020-06-12

Predictive performance of optic nerve sheath diameter for prognosis in post-cardiac arrest patients:A meta-analysis

- Department of Emergency, Cangzhou Central Hospital, Cangzhou, Hebei, 061000, China

More Information

Corresponding author: LI Yong, E-mail: ly13333367871@hotmail.com

Received Date: 12 June 2020

摘要

摘要: 目的:系统评价视神经鞘直径(ONSD)预测心搏骤停(CA)患者预后的预测价值。方法:计算机检索PubMed、ScienceDirect、Embase、Web of Science、Cochrane Library、中国知网(CNKI)、中国生物医学文献数据库、万方医学数据库等数据库,检索自建库至2020年3月10日发表的评估ONSD与CA患者预后的中英文文献。应用Stata 14.0软件对纳入的文献计算比值比(OR)及其95%可信区间(95%CI),同时绘制综合受试者工作特征曲线(SROC)得出曲线下面积(AUC),并采用敏感度分析图评估结果稳定性、Deek漏斗图评估发表偏倚及Fagan图评估ONSD的临床应用价值。结果:共纳入7篇研究,共441例CA患者。研究间存异质性(I²=43.6%,P=0.100),应用随机效应模型汇总的结果显示ONSD增宽与CA患者预后不佳相关(OR=9.12,95%CI:4.16~20.01;P<0.01)。ONSD预测CA患者预后的敏感度为0.60(95%CI:0.43~0.75),特异度为0.88(95%CI:0.76~0.95)。SROC曲线表明ONSD预测CA患者预后的曲线下面积为0.85(95%CI:0.81~0.88)。敏感度分析显示预测结果稳定。Deek检验显示研究间不存在发表偏倚(P=0.19)。Fagan图显示当验前概率为25%、50%、75%时,阴性验后概率分别为13%、31%及58%,阳性验后概率分别为63%、84%及94%。结论:ONSD有助于预测CA患者的预后。
- 视神经鞘直径 /
- 心搏骤停 /
- 神经功能 /
- meta分析
Abstract: Objective:To systematically evaluate the value of optic nerve sheath diameter(ONSD) in predicting the prognosis in post-cardiac arrest(CA) patients. Method:The Chinese and English literature regarding ONSD and prognosis in post-CA patients were searched via computer screening of databases including PubMed, ScienceDirect, Embase, Web of Science, Cochrane Library, China National Knowledge Internet(CNKI), China Technical Journal Full-text Database, and Wanfang Database from the initial publication to March 10, 2020. Predictive performance of ONSD for prognosis was presented as Odds ratio(OR) and 95% confidence interval(CI), summary receiver operating characteristic(SROC), sensitivity analysis, Deek funnel plot and Fagan plot by Stata 14.0. Result:7 studies that involved 441 post-CA patients were included in this meta-analysis. The study showed some heterogeneity(I²=43.6%, P=0.100), pooled analysis using sandom effects model demonstrated that broadened ONSD was related with poor prognosis in CA patients(OR=9.12, 95%CI:4.16-20.01; P<0.01). The sensitivity and specificity of ONSD were 0.60(95%CI:0.43-0.75) and 0.88(95%CI:0.76-0.95), respectively. SROC curve showed the area under the curve of ONSD was 0.85(95%CI:0.81-0.88). Deek test showed no interstudy publication bias(P=0.19). Fagan plot showed that with the pretest probability of 25%, 50% and 75%, the negative post-test probability was 13%, 31%, and 58%, and the positive post-test probability was 63%, 84%, and 94%, respectively.Conclusion:ONSD has a good predictive performance for the prognosis in post-CA patients.
- optic nerve sheath diameter /
- cardiac arrest /
- neurologic function /
- meta-analysis

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