{"title":"Prognostic role of quantitative pupillometry in traumatic brain injury: a scoping review.","authors":"Iman Kiani, Mohammadamin Parsaei, Hanie Karimi, Alireza Beikmarzehei, Shahnaz Fooladi Sarabi, Pegah Pezhdam, Mehranoosh Nouri Khoramabadian, Mojtaba Shahbazi, Maryam Masoudi, Hossein Sanjari Moghaddam","doi":"10.1007/s10072-024-07869-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a major cause of global mortality and disability, leading to primary and secondary brain injuries that can result in severe neurological, cognitive, and psychological impairments. Accurate and early prognosis of TBI outcomes is critical, particularly in assessing the risk of neurological decline, intracranial pressure (ICP) changes, and mortality.</p><p><strong>Objective: </strong>This systematic review aims to evaluate the prognostic value of quantitative pupillometry, particularly the Neurological Pupil Index (NPi), in predicting long-term outcomes in TBI patients.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines, with the protocol registered on PROSPERO (CRD42023489079). Databases including PubMed, Scopus, and Embase were searched. Studies were included based on predefined inclusion criteria, focusing on the prognostic accuracy of automated pupillometry in TBI patients. Risk of bias was assessed using the Joanna Briggs Institute (JBI) tool, and evidence quality was evaluated using the Best-Evidence Synthesis approach.</p><p><strong>Results: </strong>Thirteen studies met the inclusion criteria, with sample sizes ranging from 36 to 2258 participants. The studies demonstrated a consistent association between lower NPi values and increased mortality, poorer functional outcomes, elevated ICP, and the need for emergency interventions. Despite variability in study design and sample sizes, strong evidence supported the use of NPi as a reliable prognostic tool in TBI management.</p><p><strong>Conclusion: </strong>Automated infrared pupillometry, particularly through NPi measurement, offers important prognostic value in TBI patients. Incorporating NPi into routine clinical practice could improve the accuracy of prognosis and enhance patient management. Future research should focus on standardizing measurement protocols and validating these findings in larger, more diverse cohorts.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"1169-1177"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurological Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10072-024-07869-y","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Traumatic brain injury (TBI) is a major cause of global mortality and disability, leading to primary and secondary brain injuries that can result in severe neurological, cognitive, and psychological impairments. Accurate and early prognosis of TBI outcomes is critical, particularly in assessing the risk of neurological decline, intracranial pressure (ICP) changes, and mortality.
Objective: This systematic review aims to evaluate the prognostic value of quantitative pupillometry, particularly the Neurological Pupil Index (NPi), in predicting long-term outcomes in TBI patients.
Methods: A systematic review was conducted following PRISMA guidelines, with the protocol registered on PROSPERO (CRD42023489079). Databases including PubMed, Scopus, and Embase were searched. Studies were included based on predefined inclusion criteria, focusing on the prognostic accuracy of automated pupillometry in TBI patients. Risk of bias was assessed using the Joanna Briggs Institute (JBI) tool, and evidence quality was evaluated using the Best-Evidence Synthesis approach.
Results: Thirteen studies met the inclusion criteria, with sample sizes ranging from 36 to 2258 participants. The studies demonstrated a consistent association between lower NPi values and increased mortality, poorer functional outcomes, elevated ICP, and the need for emergency interventions. Despite variability in study design and sample sizes, strong evidence supported the use of NPi as a reliable prognostic tool in TBI management.
Conclusion: Automated infrared pupillometry, particularly through NPi measurement, offers important prognostic value in TBI patients. Incorporating NPi into routine clinical practice could improve the accuracy of prognosis and enhance patient management. Future research should focus on standardizing measurement protocols and validating these findings in larger, more diverse cohorts.
期刊介绍：
Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.
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