A differential of the left eye and right eye neurological pupil index is associated with discharge modified Rankin scores in neurologically injured patients

• DOI: 10.1186/s12883-022-02801-3
• Publication Date: 2022-07-22T07:03:02Z
• Authors: Claudio M. Privitera; Sanjay V. Neerukonda; Venkatesh Aiyagari; Shoji Yokobori; Ava M. Puccio; Nathan J. Schneider; Sonja E. Stutzman; DaiWai M. Olson; ; Michelle Hill; Jessica DeWitt; Folefac Atem; Arianna Barnes; Donglu Xie; Joji Kuramatsu; Julia Koehn; Stefan Swab
• Keywords: Pupillometry; Stroke; Neurological examination

Abstract Background Automated infrared pupillometry (AIP) and the Neurological Pupil index (NPi) provide an objective means of assessing trending pupillary light reflex (PLR) across a broad spectrum neurological diseases. NPi quantifies PLR ranges from 0 to 5; in healthy individuals, both eyes is expected be ≥ 3.0 symmetric. AIP values demonstrate emerging value as prognostic tool with predictive properties that could allow practitioners anticipate deterioration recovery. The presence differential (a difference 0.7 between left right eye) potential sign abnormality. Methods We explored by considering modified Rankin Score at discharge (DC mRS) among patients admitted neuroscience intensive care units (NSICU) 4 U.S. 1 Japanese hospitals for two cohorts brain injuries: stroke (including subarachnoid hemorrhage, intracerebral acute ischemic stroke, aneurysm, 1,200 total patients) 185 traumatic injury (TBI) more than 54,000 measurements. Results Stroke least occurrence during their NSICU stay have higher DC mRS scores (3.9) compared those without (2.7; P < .001). Patients TBI Scale (4.1) (2.9; When experience abnormalities, abnormal (NPi 3.0) differential, latter has anticipatory relationship respect former ( .001 z-score skewness analysis). Finally, our analysis confirmed optimal cutoff (AUC = 0.71, Conclusion important factor clinicians should consider when managing critically ill injured neurocritical units. Trial registration NCT02804438 , Date Registration: June 17, 2016.