Neuroanesthesia & neurocritical care
Neuromonitoring with near-infrared spectroscopy (NIRS) in aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis
Pooled result · Unfavourable outcomeResult — go to the resultRelative risk 4.29 95% CI 2.10–8.79Authors' conclusion
Cerebral desaturation events and impaired autoregulation detected by NIRS are consistently associated with poor outcomes and mortality in aSAH. However, NIRS alone provides only moderate diagnostic accuracy for DCI, with a considerable risk of false positives.
Study context
- Population
- Adult aneurysmal subarachnoid hemorrhage (aSAH) patients monitored with NIRS during index hospitalization3 studies, primary outcome
- Participants
- 202 patients
- Comparison
- NIRS-detected cerebral desaturation events or loss of autoregulation vs none
- Outcome
- Functional outcome (unfavourable outcome)
- Follow-up
- 90 days or more
Methodological detailsrandom effects meta-analyses, 35 studies of 28,296 citations met inclusion criteria, Evidence limited by small samples, high heterogeneity and potential publication bias
- Random effects meta-analyses
- 35 studies of 28,296 citations met inclusion criteria
- Evidence limited by small samples, high heterogeneity and potential publication bias
Pooled result
Unfavourable outcome · 90 days
Relative risk
4.29
95% CI 2.10–8.79
NIRS desaturation/loss of autoregulation vs No desaturation/intact autoregulation
RR 4.29 (95% CI 2.10–8.79)
As reported in the abstract
Further pooled results
Diagnostic accuracy of NIRS for DCI
- Sensitivity
- 0.85
- Specificity
- 0.65
- Diagnostic OR
- 10.42
- ROC curve area
- 0.68
- Low certainty of evidence
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Neuromonitoring with near-infrared spectroscopy (NIRS) in aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis. Crit Care. Published 14 November 2025. doi:10.
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