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 <3 was highly predictive of unfavourable outcome, with highest specificity (100% (90–100)) at day 3 (sensitivity 24% (15–35), negative predictive value 36% (34–39)). The addition of NPi, from day 1 following ABI to age and cerebral CT scan, provided the best prognostic performance (AUROC curve 0.85 vs. 0.78 without 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.

Romagnosi, F., Bernini, A., Bongiovanni, F., Iaquaniello, C., Miroz, J., Citerio, G., et al. (2022). Neurological Pupil Index for the Early Prediction of Outcome in Severe Acute Brain Injury Patients. BRAIN SCIENCES, 12(5) [10.3390/brainsci12050609].

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

Iaquaniello, Carolina;Citerio, Giuseppe;
2022

Abstract

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 <3 was highly predictive of unfavourable outcome, with highest specificity (100% (90–100)) at day 3 (sensitivity 24% (15–35), negative predictive value 36% (34–39)). The addition of NPi, from day 1 following ABI to age and cerebral CT scan, provided the best prognostic performance (AUROC curve 0.85 vs. 0.78 without 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.
Articolo in rivista - Articolo scientifico
acute brain injury; midline shift; neurological prognosis; Neurological Pupil index; quantitative pupillometry;
English
Romagnosi, F., Bernini, A., Bongiovanni, F., Iaquaniello, C., Miroz, J., Citerio, G., et al. (2022). Neurological Pupil Index for the Early Prediction of Outcome in Severe Acute Brain Injury Patients. BRAIN SCIENCES, 12(5) [10.3390/brainsci12050609].
Romagnosi, F; Bernini, A; Bongiovanni, F; Iaquaniello, C; Miroz, J; Citerio, G; Taccone, F; Oddo, M
File in questo prodotto:
File Dimensione Formato  
brainsci-12-00609.pdf

accesso aperto

Tipologia di allegato: Publisher’s Version (Version of Record, VoR)
Dimensione 941.5 kB
Formato Adobe PDF
941.5 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/373610
Citazioni
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 2
Social impact