To investigate the association between ultra-early quantitative pupillometry indices measured within the first 24 h of emergency department arrival and clinical outcomes in patients with acute brain injury, specifically those admitted to the ICU for conditions such as aneurysmal subarachnoid hemorrhage, traumatic brain injury, intracerebral hemorrhage, and ischemic stroke.
Approach:
Key Findings:
ICU mortality was 29.8% among 168 patients.
Worsened and Consistently low NPi trajectory groups had higher ICU mortality compared to the Consistently high group (p < 0.01).
Incorporating NPi trajectories improved predictive accuracy for ICU mortality (AUROC, 0.89 vs. 0.80, p < 0.01), 6-month mortality (0.83 vs. 0.76, p = 0.01), and poor functional outcomes (0.87 vs. 0.82, p = 0.06).
Interpretation:
Ultra-early changes in pupillometry indices during the hyperacute phase enhance risk stratification and improve outcome prediction in acute brain injury.
Limitations:
Retrospective nature of the study may introduce bias.
Findings are based on a single-center cohort, limiting generalizability and potentially affecting the applicability of results to broader populations.
Conclusion:
Ultra-early pupillometry indices can provide valuable insights into patient outcomes in acute brain injury.
by Yong Soo Kim, Dong-Wan Kang, Hyung Seok Guk, Museong Kim, Heewon Jeong, Huimahn Alex Choi, Sung-Min Cho, Moon-Ku Han, Hee Eun Kim, Dong Keon Lee, Han-Gil Jeong
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