Neurological Pupil Index for the Early Prediction of Outcome in Severe Acute Brain Injury Patients

Federico Romagnosi; Adriano Bernini; Filippo Bongiovanni; Carolina Iaquaniello; John-Paul Miroz; Giuseppe Citerio; Fabio Silvio Taccone; Mauro Oddo

doi:10.3390/brainsci12050609

Brain Sciences (May 2022)

Neurological Pupil Index for the Early Prediction of Outcome in Severe Acute Brain Injury Patients

Federico Romagnosi,
Adriano Bernini,
Filippo Bongiovanni,
Carolina Iaquaniello,
John-Paul Miroz,
Giuseppe Citerio,
Fabio Silvio Taccone,
Mauro Oddo

Affiliations

Federico Romagnosi: Neuroscience Critical Care Group, Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
Adriano Bernini: Neuroscience Critical Care Group, Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
Filippo Bongiovanni: Neuroscience Critical Care Group, Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
Carolina Iaquaniello: Neuroscience Critical Care Group, Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
John-Paul Miroz: Neuroscience Critical Care Group, Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
Giuseppe Citerio: Department of Neuroscience ASST-Monza, University of Milano—Bicocca, 20900 Monza, Italy
Fabio Silvio Taccone: Department of Intensive Care Medicine, Erasme Hospital, Université Libre de Bruxelles, 1050 Brussels, Belgium
Mauro Oddo: Neuroscience Critical Care Group, Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland

DOI: https://doi.org/10.3390/brainsci12050609
Journal volume & issue: Vol. 12, no. 5
p. 609

Abstract

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In this study, we examined the early value of automated quantitative pupillary examination, using the Neurological Pupil index (NPi), to predict the long-term outcome of acute brain injured (ABI) patients. We performed a single-centre retrospective study (October 2016–March 2019) in ABI patients who underwent NPi measurement during the first 3 days following brain insult. We examined the performance of NPi—alone or in combination with other baseline demographic (age) and radiologic (CT midline shift) predictors—to prognosticate unfavourable 6-month outcome (Glasgow Outcome Scale 1–3). A total of 145 severely brain-injured subjects (65 traumatic brain injury, TBI; 80 non-TBI) were studied. At each time point tested, NPi p = 0.008; DeLong test) for 6-month neurological outcome prediction. NPi, assessed at the early post-injury phase, has a superior ability to predict unfavourable long-term neurological outcomes in severely brain-injured patients. The added prognostic value of NPi was most significant when complemented with baseline demographic and radiologic information.

Published in Brain Sciences

ISSN: 2076-3425 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.mdpi.com/journal/brainsci/

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