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1
The QPi is recorded as an integer from 0 to 5, whereas the NPi is continuous from 0 to 4.9, amplifying discordance near the QPi abnormality cutoff of less than 3.
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2
In brain-injured patients, median NPi was 4.3 and median QPi was 3; abnormal-value proportions were 1.2% for NPi and 12.7% for QPi.
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3
In sedated patients without brain injury, sufentanil and propofol lowered QPi below 3 while NPi remained above 4, and low QPi was associated with resting pupil diameter below approximately 2.7 mm.
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4
Sedation-related QPi reduction may be associated with poor outcomes through treatment burden, but the authors state that it should not be interpreted as evidence of neurological deterioration.
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5
The authors recommend studying discordance with measurements of pupil diameter and sedation exposure, and conclude that abnormal QPi with normal NPi should prompt evaluation of these factors.
