Evidence map›Paper›PMID 37298001›Full record

ArticleJournal of clinical medicine2023

Neurological Pupillary Index and Disposition at Hospital Discharge following ICU Admission for Acute Brain Injury.

Abhijit V Lele, Sarah Wahlster, Sunita Khadka, Andrew M Walters, Christine T Fong, Patricia A Blissitt, Sarah L Livesay, Gemi E Jannotta, Bernice G Gulek, Vasisht Srinivasan and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Abhijit V LeleNeurocritical Care Service, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.ORCID 0000-0002-6956-538X
Sarah WahlsterNeurocritical Care Service, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
Sunita KhadkaNeurocritical Care Service, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
Andrew M WaltersDepartment of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
Christine T FongDepartment of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
Patricia A BlissittDepartment of Nursing, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
Sarah L LivesayNeurocritical Care Service, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
Gemi E JannottaNeurocritical Care Service, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.ORCID 0000-0002-2344-2894
Bernice G GulekNeurocritical Care Service, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.ORCID 0000-0002-1676-2961
Vasisht SrinivasanNeurocritical Care Service, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
Kathryn RosenblattDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Michael J SouterNeurocritical Care Service, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
Monica S VavilalaDepartment of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA.
University of Washington · USJohns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We examined the associations between the Neurological Pupillary Index (NPi) and disposition at hospital discharge in patients admitted to the neurocritical care unit with acute brain injury (ABI) due to acute ischemic stroke (AIS), spontaneous intracerebral hemorrhage (sICH), aneurysmal subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI). The primary outcome was discharge disposition (home/acute rehabilitation vs. death/hospice/skilled nursing facility). Secondary outcomes were tracheostomy tube placement and transition to comfort measures. Among 2258 patients who received serial NPi assessments within the first seven days of ICU admission, 47.7% (n = 1078) demonstrated NPi ≥ 3 on initial and final assessments, 30.1% (n = 680) had initial NPI < 3 that never improved, 19% (n = 430) had initial NPi ≥ 3, which subsequently worsened to <3 and never recovered, and 3.1% (n = 70) had initial NPi < 3, which improved to ≥3. After adjusting for age, sex, admitting diagnosis, admission Glasgow Coma Scale score, craniotomy/craniectomy, and hyperosmolar therapy, NPi values that remained <3 or worsened from ≥3 to <3 were associated with poor outcomes (adjusted odds ratio, aOR 2.58, 95% CI [2.03; 3.28]), placement of a tracheostomy tube (aOR 1.58, 95% CI [1.13; 2.22]), and transition to comfort measures only (aOR 2.12, 95% CI [1.67; 2.70]). Our study suggests that serial NPi assessments during the first seven days of ICU admission may be helpful in predicting outcomes and guiding clinical decision-making in patients with ABI. Further studies are needed to evaluate the potential benefit of interventions to improve NPi trends in this population.

Indexed as

automated pupillometryneurocritical careneurological pupillary indexNPioutcomespupillometer

Identifiers

PMID37298001
PMCPMC10253644
OpenAlexW4379184970

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.