Acil Serviste Hipertansiyonu Olan Hastalarda Optik Sinir Kılıf Çapı Ölçümü

Abstract

DANIŞ F, Optic Nerve Sheath Diameter Measurement in Patients with Hypertension in the Emergency Department, Hacettepe University Faculty of Medicine, Emergency Medicine Thesis. Ankara, 2021. One of the methods employed to evaluate the intracranial pressure is the evaluation of the Optical Nerve Sheath Diameter (ONSD). The purpose of the present study was to diagnose patients admitting to Emergency Department due to hypertensive crisis in early period, apply a relevant treatment method, and to reduce the morbidity and mortality associated with the disease. In our study, it was planned to investigate the correlation of ONSD measured with USG with patient’s blood pressure, the blood pressure threshold, which indicates increased ONSD, and the value of ONSD in predicting the discharge of patients admitting to Emergency Department with hypertensive crisis. A total of 112 patients admitted to Hacettepe University Emergency Department with preliminary diagnosis of hypertensive emergency were included in the study. Admission blood pressures and blood pressures 1 hour after reaching target blood pressures were recorded together with ONSD measurements. According to our study, a positive correlation was found between ONSD values and systolic blood pressure of patients who were diagnosed with hypertensive priority condition; and that 21% of the change in ONSD levels occurred with systolic blood pressure. According to the analyses, the systolic blood pressure threshold value with the highest sensitivity and specificity to indicate increased ONSD was 192 mmHg. This finding suggests that attention must be paid to patients with systolic blood pressure ≥192 mmHg admitting to Emergency Department in terms of increased intracranial pressure. According to the results of our study, it was found that the highest sensitivity and specificity value to indicate hospitalization was achieved when ONSD cut-off value was 5.6 mm. ONSD measurement can be used as a clinical aid in predicting hypertensive emergency, determining increased intracranial pressure, and evaluating the need for hospitalization in patients admitting with hypertensive crisis.