Cardiac arrest & resuscitation
Correlation Between Quantitative Pupillometry and Other Markers for Neuroprognostication of Comatose Patients After Cardiac Arrest: A Bicentric Study
Authors' conclusion
In comatose patients after CA, qPLR is tightly correlated with other prognostic markers; low qPLR and NPi less than or equal to 2 appeared highly specific for poor outcome, but performances do not exceed that of clinical PLR. Finally, high qPLR remained limited in predicting a good outcome.
Study context
- Population
- Comatose adults after cardiac arrest with pupillometry during the first 48–72 hours, Lausanne and Paris, 2020–2024
- Participants
- 442 adults
- Comparison
- Quantitative pupillary light reflex and Neurological Pupil index (NPi) vs other prognostic markers
- Outcome
- Prediction of poor outcome
- Follow-up
- 3 months
Methodological detailsanalysis of prospective registries, bicentric
- Analysis of prospective registries
- Bicentric
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity |
|---|---|---|
| Minimum quantitative pupillary light reflex (qPLR) <2% | 23.6% | 96.4% |
| Maximum qPLR <13% | 19.0% | 96.4% |
| NPi ≤2 | 34% | 99% |
| Qualitative PLR | 38.9 | — not stated in the abstract |
Sensitivity
Minimum quantitative pupillary light reflex (qPLR) <2%23.6%
Maximum qPLR <13%19.0%
NPi ≤234%
Qualitative PLR38.9
Specificity
Minimum quantitative pupillary light reflex (qPLR) <2%96.4%
Maximum qPLR <13%96.4%
NPi ≤299%
Qualitative PLR— not stated in the abstract
— not stated in the abstract
- Qualitative PLR vs Minimum qPLR <2%, Maximum qPLR <13%: P < 0.001 — qualitative PLR higher sensitivity with comparable specificity
Further findings
Prediction of good outcome (CPC 1-2) · 3 months
Specificity
Sensitivity
qPLR and clinical/EEG/SSEP markers
- Minimum and maximum qPLR lower with early myoclonus
- P < 0.001
- Lower with bilateral N20 SSEP absence
- P < 0.001
- Lower with unreactive EEG
- P < 0.001
- Lower with epileptiform EEG
- P = 0.03 and 0.05
- Lower with suppressed EEG vs discontinuous and continuous background
- P < 0.001
Correlation with serum neuron-specific enolase (NSE) at 48 hours
- Minimum qPLR, Spearman Rho
- −0.283; p < 0.001
- Maximum qPLR, R
- −0.444; p < 0.001
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Correlation Between Quantitative Pupillometry and Other Markers for Neuroprognostication of Comatose Patients After Cardiac Arrest: A Bicentric Study. Crit Care Med. Published 11 June 2026. doi:10.
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