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Anisocoria Correlates With Injury Severity and Outcomes After Blunt Traumatic Brain Injury
- Source :
- Journal of Neuroscience Nursing. 53:251-255
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- BACKGROUND: Automated infrared pupillometry (AIP) has been shown to be helpful in the setting of aneurysmal subarachnoid hemorrhage and stroke as an indicator of imminent irreversible brain injury. We postulated that the early detection of pupillary dysfunction after light stimulation using AIP may be useful in patients with traumatic brain injury (TBI). METHODS: We performed a retrospective review of the Establishing Normative Data for Pupillometer Assessment in Neuroscience Intensive Care database, a prospectively populated multicenter registry of patients who had AIP measurements taken during their intensive care unit admission. The primary eligibility criterion was a diagnosis of blunt TBI. Ordinal logistic modeling was used to explore the association between anisocoria and daily Glasgow Coma Scale scores and discharge modified Rankin Scale scores from the intensive care unit and from the hospital. RESULTS: Among 118 subjects in the who met inclusion, there were 6187 pupillometer readings. Of these, anisocoria in ambient light was present in 12.8%, and that after light stimulation was present in 9.8%. Anisocoria after light stimulation was associated with worse injury severity (odds ratio [OR], 0.26 [95% confidence interval (CI), 0.14-0.46]), lower discharge Glasgow Coma Scale scores (OR, 0.28 [95% CI, 0.17-0.45]), and lower discharge modified Rankin Scale scores (OR, 0.28 [95% CI, 0.17-0.47]). Anisocoria in ambient light showed a similar but weaker association. CONCLUSION: Anisocoria correlates with injury severity and with patient outcomes after blunt TBI. Anisocoria after light stimulation seems to be a stronger predictor than does anisocoria in ambient light. These findings represent continued efforts to understand pupillary changes in the setting of TBI.
- Subjects :
- Subarachnoid hemorrhage
Traumatic brain injury
law.invention
law
Modified Rankin Scale
Intensive care
Brain Injuries, Traumatic
medicine
Humans
Glasgow Coma Scale
Prospective Studies
Stroke
Retrospective Studies
Anisocoria
Endocrine and Autonomic Systems
business.industry
medicine.disease
Intensive care unit
Medical–Surgical Nursing
Anesthesia
Surgery
Neurology (clinical)
medicine.symptom
business
Subjects
Details
- ISSN :
- 19452810 and 08880395
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- Journal of Neuroscience Nursing
- Accession number :
- edsair.doi.dedup.....9271e1bed071826d5222e969dfc27312