A differential of the left eye and right eye neurological pupil index is associated with discharge modified Rankin scores in neurologically injured patients
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Le résumé fourni par la source
BACKGROUND: Automated infrared pupillometry (AIP) and the Neurological Pupil index (NPi) provide an objective means of assessing and trending the pupillary light reflex (PLR) across a broad spectrum of neurological diseases. NPi quantifies the PLR and ranges from 0 to 5; in healthy individuals, the NPi of both eyes is expected to be ≥ 3.0 and symmetric. AIP values demonstrate emerging value as a prognostic tool with predictive properties that could allow practitioners to anticipate neurological deterioration and recovery. The presence of an NPi differential (a difference ≥ 0.7 between the left and right eye) is a potential sign of neurological abnormality. METHODS: We explored NPi differential by considering the modified Rankin Score at discharge (DC mRS) among patients admitted to neuroscience intensive care units (NSICU) of 4 U.S. and 1 Japanese hospitals and for two cohorts of brain injuries: stroke (including subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, and aneurysm, 1,200 total patients) and 185 traumatic brain injury (TBI) patients for a total of more than 54,000 pupillary measurements. RESULTS: Stroke patients with at least 1 occurrence of an NPi differential during their NSICU stay have higher DC mRS scores (3.9) compared to those without an NPi differential (2.7; P < .001). Patients with TBI and at least 1 occurrence of an NPi differential during their NSICU stay have higher discharge modified Rankin Scale scores (4.1) compared to those without an NPi differential (2.9; P < .001). When patients experience both abnormalities, abnormal (NPi < 3.0) and an NPi differential, the latter has an anticipatory relationship with respect to the former (P < .001 for z-score skewness analysis). Finally, our analysis confirmed ≥ 0.7 as the optimal cutoff value for the NPi differential (AUC = 0.71, P < .001). CONCLUSION: The NPi differential is an important factor that clinicians should consider when managing critically ill neurological injured patients admitted to the neurocritical care units. TRIAL REGISTRATION: NCT02804438 , Date of Registration: June 17, 2016.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- A differential of the left eye and right eye neurological pupil index is associated with discharge modified Rankin scores in neurologically injured patients
- Date Crossref
- 22/07/2022
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of California pays non établi dans la noticeUniversité ou école supérieure
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The University of Texas at Dallas pays non établi dans la noticeUniversité ou école supérieure
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The University of Texas Southwestern Medical Center Division of Neurocritical Care pays non établi dans la noticeÉtablissement de santé
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Neurological Surgery pays non établi dans la noticeÉtablissement de santé
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Nippon Medical School pays non établi dans la noticeUniversité ou école supérieure
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University of Pittsburgh Medical Center Department of Neurological Surgery pays non établi dans la noticeÉtablissement de santé
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Southwestern Medical Center pays non établi dans la noticeÉtablissement de santé
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School of Optometry pays non établi dans la noticeUniversité ou école supérieure
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School of Behavioral and Brain Sciences pays non établi dans la noticeUniversité ou école supérieure
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Department of Emergency and Critical Care Medicine pays non établi dans la noticeInstitution
University of California, The University of Texas at Dallas et Division of Neurocritical Care — The University of Texas Southwestern Medical Center, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.