Early outcome prediction with quantitative pupillary response parameters after out-of-hospital cardiac arrest: A multicenter prospective observational study​

Tamura, Tomoyoshi; Namiki, Jun; Sugawara, Yoko; Sekine, Keitaro; Yo, Kikuo; Kanaya, Takahiro; Yokobori, Shoji; Abe, Takayuki; Yokota, Hiroyuki; Sasaki, Junichi

doi:10.1371/journal.pone.0228224

Cited by 23 publications

(20 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results support the hypothesis that dilation velocity varies with the severity of brain injury. ( 23 - 27 ) These findings extend those of many recent publications that have focused primarily on the NPi, a derived summary score indexed to normal. Lussier et al ( 28 ) recently published that normal DV in critically ill patients ranges significantly (0.3 - 1.1); however, this was a population average and did not utilize machine learning to assess the statistical validity based on groupings.…”

Section: Discussionsupporting

confidence: 81%

Identification of abnormal pupil dilation velocity as a biomarker of cerebral injury in neurocritically ill patients

Singh¹,

Stutzman²,

Venkatachalam³

et al. 2021

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

Objetivo Calcular as velocidades médias da dilatação de pupila para classificar a gravidade da lesão derivada da escala de coma de Glasgow, estratificada por variáveis de confusão. Métodos Neste estudo, analisaram-se 68.813 exames das pupilas para determinar a velocidade normal de dilatação em 3.595 pacientes com lesão cerebral leve (13 - 15), moderada (9 - 12) ou grave (3 - 8), segundo a escala de coma de Glasgow. As variáveis idade, sexo, raça, tamanho da pupila, tempo de permanência na unidade de terapia intensiva, pressão intracraniana, uso de narcóticos, classificação pela escala de coma de Glasgow e diagnóstico foram consideradas confundidoras e controladas para análise estatística. Empregou-se regressão logística com base em algoritmo de classificação com aprendizado de máquina para identificar os pontos de corte da velocidade de dilatação para as categorias segundo a escala de coma de Glasgow. Resultados As razões de chance e os intervalos de confiança desses fatores se mostraram estatisticamente significantes em sua influência sobre a velocidade de dilatação. A classificação com base na área sob a curva mostrou que, para o grau leve, na escala de coma de Glasgow, o limite da velocidade de dilatação foi de 1,2mm/s, com taxas de falsa probabilidade de 0,1602 e 0,1902 e áreas sob a curva de 0,8380 e 0,8080, respectivamente, para os olhos esquerdo e direito. Para grau moderado na escala de coma de Glasgow, a velocidade de dilatação foi de 1,1mm/s com taxas de falsa probabilidade de 0,1880 e 0,1940 e áreas sob a curva de 0,8120 e 0,8060, respectivamente, nos olhos esquerdo e direito. Mais ainda, para o grau grave na escala de coma de Glasgow, a velocidade de dilatação foi de 0,9mm/s, com taxas de falsa probabilidade de 0,1980 e 0,2060 e áreas sob a curva de 0,8020 e 0,7940, respectivamente, nos olhos esquerdo e direito. Esses valores foram diferentes dos métodos prévios de descrição subjetiva e das velocidades de dilatação previamente estimadas. Conclusão Observaram-se velocidades mais lentas de dilatação pupilar em pacientes com escores mais baixos na escala de coma de Glasgow, indicando que diminuição da velocidade pode indicar grau mais grave de lesão neuronal.

show abstract

Section: Discussionsupporting

confidence: 81%

Identification of abnormal pupil dilation velocity as a biomarker of cerebral injury in neurocritically ill patients

Singh¹,

Stutzman²,

Venkatachalam³

et al. 2021

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

show abstract

“…Previous studies have revealed various factors, such as older age, cardiac arrest occurring at home, initial rhythm other than ventricular tachycardia/ventricular fibrillation, longer duration of no flow, longer duration of low flow, treatment with adrenaline (epinephrine), pupillary response, and a serum lactate level, as prognostic factors for OHCA patients [ 16 – 20 ]. Despite the prognosis scores proposed using these predictors [ 4 – 9 ], prognostication of OHCA patients remains challenging, and no single risk-assessment tool has been recommended for the prognostic classification of OHCA patients.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous external validation of various cardiac arrest prognostic scores: a single-center retrospective study

Tsuchida

Ono²,

Maekawa

et al. 2021

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

Background This study aimed to compare and validate the out-of-hospital cardiac arrest (OHCA); cardiac arrest hospital prognosis (CAHP); non-shockable rhythm, unwitnessed arrest, long no-flow or long low-flow period, blood pH < 7.2, lactate > 7.0 mmol/L, end-stage chronic kidney disease, age ≥ 85 years, still resuscitation, and extracardiac cause (NULL-PLEASE) clinical; post-cardiac arrest syndrome for therapeutic hypothermia (CAST); and revised CAST (rCAST) scores in OHCA patients treated with recent cardiopulmonary resuscitation strategies. Methods We retrospectively collected data on adult OHCA patients admitted to our emergency department between February 2015 and July 2018. OHCA, CAHP, NULL-PLEASE clinical, CAST, and rCAST scores were calculated based on the data collected. The predictive abilities of each score were tested using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results We identified 236 OHCA patients from computer-based medical records and analyzed 189 without missing data. In OHCA patients without bystander witnesses, CAHP and OHCA scores were not calculated. Although the predictive abilities of the scores were not significantly different, the NULL-PLEASE score had a large AUC of ROC curve in various OHCA patients. Furthermore, in patients with bystander-witnessed OHCA, the NULL-PLEASE score had large partial AUCs of ROC from sensitivity 0.8–1.0 and specificity 0.8–1.0. Conclusions The NULL-PLEASE score had a high, comprehensive predictive ability in various OHCA patients. Furthermore, the NULL-PLEASE score had a high predictive ability for good and poor neurological outcomes in patients with bystander-witnessed OHCA.

show abstract

“…Previous studies have revealed various factors, such as older age, cardiac arrest occurring at home, initial rhythm other than ventricular tachycardia/ventricular brillation, longer duration of no ow, longer duration of low ow, treatment with adrenaline (epinephrine), pupillary response, and a serum lactate level, as prognostic factors for OHCA patients [16][17][18][19][20]. Despite the prognosis scores proposed using these predictors [4][5][6][7][8][9], prognostication of OHCA patients remains challenging, and no single riskassessment tool has been recommended for the prognostic classi cation of OHCA patients.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous External Validation of Various Cardiac Arrest Prognostic Scores: a Single-center Retrospective Study

Tsuchida

Ono²,

Maekawa

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: This study aimed to compare and validate the out-of-hospital cardiac arrest (OHCA); cardiac arrest hospital prognosis (CAHP); non-shockable rhythm, unwitnessed arrest, long no-flow or long low-flow period, blood pH < 7.2, lactate > 7.0 mmol/L, end-stage chronic kidney disease, age ≥ 85 years, still resuscitation, and extracardiac cause (NULL-PLEASE) clinical; post-cardiac arrest syndrome for therapeutic hypothermia (CAST); and revised CAST (rCAST) scores in OHCA patients treated with recent cardiopulmonary resuscitation strategies.Methods: We retrospectively collected data on adult OHCA patients admitted to our emergency department between February 2015 and July 2018. OHCA, CAHP, NULL-PLEASE clinical, CAST, and rCAST scores were calculated based on the data collected. The predictive abilities of each score were tested using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.Results: We identified 236 OHCA patients from computer-based medical records and analyzed 189 without missing data. In OHCA patients without bystander witnesses, CAHP and OHCA scores were not calculated. Although the predictive abilities of the scores were not significantly different, the NULL-PLEASE score had a large AUC of ROC curve in various OHCA patients. Furthermore, in patients with bystander-witnessed OHCA, the NULL-PLEASE score had large partial AUCs of ROC from sensitivity 0.8 to 1.0 and specificity 0.8 to 1.0. Conclusions: The NULL-PLEASE score had a high, comprehensive predictive ability in various OHCA patients. Furthermore, the NULL-PLEASE score had a high predictive ability for good and poor neurological outcomes in patients with bystander-witnessed OHCA.

show abstract

Early outcome prediction with quantitative pupillary response parameters after out-of-hospital cardiac arrest: A multicenter prospective observational study

Cited by 23 publications

References 32 publications

Identification of abnormal pupil dilation velocity as a biomarker of cerebral injury in neurocritically ill patients

Identification of abnormal pupil dilation velocity as a biomarker of cerebral injury in neurocritically ill patients

Simultaneous external validation of various cardiac arrest prognostic scores: a single-center retrospective study

Simultaneous External Validation of Various Cardiac Arrest Prognostic Scores: a Single-center Retrospective Study

Contact Info

Product

Resources

About

Early outcome prediction with quantitative pupillary response parameters after out-of-hospital cardiac arrest: A multicenter prospective observational study​

Cited by 23 publications

References 32 publications

Identification of abnormal pupil dilation velocity as a biomarker of cerebral injury in neurocritically ill patients

Identification of abnormal pupil dilation velocity as a biomarker of cerebral injury in neurocritically ill patients

Simultaneous external validation of various cardiac arrest prognostic scores: a single-center retrospective study

Simultaneous External Validation of Various Cardiac Arrest Prognostic Scores: a Single-center Retrospective Study

Contact Info

Product

Resources

About

Early outcome prediction with quantitative pupillary response parameters after out-of-hospital cardiac arrest: A multicenter prospective observational study