Acute cardiac care & resuscitation
Quantitative pupillometry index to prognosticate neurological outcome in unconscious cardiac arrest patients
Authors' conclusion
Abnormal QPI had comparable specificity and a higher sensitivity than NPi in predicting UO at 3 months in comatose patients after CA.
Study context
- Population
- Unconscious (Glasgow Coma Scale <9) patients admitted to the Intensive Care Unit after successful resuscitation from cardiac arrest (CA), March 2022 to October 2024included in the final analysis, 193 screened
- Participants
- 111 participantsEvents: 79 (71%)
- Predictors
- Neurological Pupil Index (NPi) and Quantitative Pupillometry Index (QPI), measured twice at 24, 48 and 72 h after CA
- Predicted outcome
- unfavourable neurological outcome (UO): Glasgow-Pittsburgh Cerebral Performance Category 3-5 at 3 months
Methodological detailstwo University hospitals in Belgium and Spain
- Two University hospitals in Belgium and Spain
Model performance
As reported in the abstract
72 h after CA
| Strategy | Sensitivity | Specificity |
|---|---|---|
| QPI ≤ 2 | 60.4 [46.0-73.5]% | 100 [87.2-100]% |
| NPi ≤ 2 | 24.5 [13.8-38.3]% | 100 [86.8-100]% |
Sensitivity
QPI ≤ 260.4 [46.0-73.5]%
NPi ≤ 224.5 [13.8-38.3]%
Specificity
QPI ≤ 2100 [87.2-100]%
NPi ≤ 2100 [86.8-100]%
Further findings
QPI positive predictive value over time
- The QPI showed an increasing positive predictive value over time
ICU mortality
- ICU mortality
- 69 (62.2%)
NPi and QPI in patients with UO · first three days
- Patients with UO showed a lower NPi and QPI during the first three days
Original publication
Quantitative pupillometry index to prognosticate neurological outcome in unconscious cardiac arrest patients. Resuscitation. Published 20 February 2026. doi:10.
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