Introduction
Methods
Study Participants
Clinical Classification of Consciousness Levels
Evaluation of Pupillary Responses to Cognitive Loads
Passive Cognitive Paradigms
Active Cognitive Paradigms
Pupillary Dilation
Sample Size and Power Calculations
Statistics Analysis
Data Sharing Statement and Code Availability
Additional Material
Ethics
Results
Characteristics | Controls (n = 26) | Patients (n = 91) | p value | ≥ MCS (n = 37)a | ≤ UWS (n = 87)a | OR (95% CI) | p value |
---|---|---|---|---|---|---|---|
Demographics | |||||||
Age, mean (SD) (yr) | 59.0 (14.8) | 60.1 (13.9) | 0.872 | 61.2 (14.9) | 60.02 (13.3) | 0.690 | |
Male, n (%) | 16 (61.5) | 63 (69.2) | 0.483 | 27 (73.0) | 59 (67.8) | 1.28 (0.51–3.39) | 0.672 |
mRS baseline, n (%) | |||||||
0–2 | 26 | 81 (89.0) | 29 (78.4) | 67 (77.0) | 0.43 (0.03–6.30) | 0.586 | |
> 2 | 0 | 6 (6.6) | 2 (5.4) | 2 (2.3) | |||
Undisclosed | 0 | 4 (4.4) | 6 (16.2) | 18 (20.7) | |||
Cause of ICU admission, n (%) | |||||||
Cardiac arrest | n/a | 45 (49.5) | 24 (64.9) | 43 (49.4) | 2.01 (0.86–4.87) | 0.117 | |
Traumatic brain injury | n/a | 2 (2.2) | 1 (2.7) | 2 (2.3) | 1.18 (0.02–23.32) | >0.99 | |
Subarachnoid hemorrhage | n/a | 25 (27.5) | 5 (13.5) | 24 (27.6) | 0.41 (0.11–1.25) | 0.108 | |
Intracerebral hemorrhage | n/a | 15 (16.5) | 7 (18.9) | 14 (16.1) | 1.21 (0.38–3.61) | 0.794 | |
Subdural hemorrhage | n/a | 4 (4.4) | 0 | 4 (4.6) | 0 (0–3.56) | 0.316 | |
Prior comorbidity, any, n (%) | |||||||
Cardiopulmonary | n/a | 43 (47.3) | 18 (48.6) | 40 (46.0) | 0.87 (0.37–2.07) | 0.842 | |
Neurological | n/a | 7 (7.7) | 6 (16.2) | 6 (6.9) | 2.59 (0.64–10.51) | 0.180 | |
Cerebrovascular | n/a | 5 (5.49) | 5 (13.5) | 4 (4.6) | 3.21 (0.65–17.24) | 0.125 | |
Epilepsy | n/a | 1 (1.1) | 1 (2.7) | 1 (1.1) | 2.37 (0.03–189.36) | 0.509 | |
Migraine | n/a | 1 (1.1) | 0 | 1 (1.1) | 0 (0–91.57) | >0.99 | |
Diabetes | n/a | 7 (7.7) | 1 (2.7) | 6 (6.9) | 0.38 (0.01–3.29) | 0.673 | |
Other medical or surgical comorbiditiesb | n/a | 47 (51.6) | 3 (8.1) | 44 (50.6) | 0.09 (0.02–0.31) | < 0.001 | |
Clinical examinations and pupillometry sessions | |||||||
Number of clinical examinationsc | 26 | 178 | 48 | 130 | |||
GCS, at clinical examination, median (min, max) | 15 | 5 (3, 15) | < 0.001 | 11 (5, 15) | 3 (3, 9) | < 0.001 | |
FOUR, at clinical examination, median (min, max) | 16 | 5 (0, 16) | < 0.001 | 13 (5, 16) | 4 (0, 10) | < 0.001 | |
Number of automated pupillometry examinations | |||||||
Visual | 26 | 177 | 48 | 129 | |||
Auditory | 26 | 177 | 48 | 129 | |||
Mental arithmetic (moderate) | 26 | 177 | 48 | 129 | |||
Mental arithmetic (hard) | 26 | 168 | 41 | 127 | |||
Level of sedation, during clinical examination, n (%)d | |||||||
None or minimal | n/a | 75 (42.1) | < 0.001 | 41 (85.4) | 34 (26.2) | 16.21 (6.44–47.06) | < 0.001 |
Low to moderate | n/a | 17 (9.6) | 0.137 | 4 (8.3) | 13 (10.0) | 0.82 (0.18–2.84) | >0.99 |
High or very high | n/a | 86 (48.3) | < 0.001 | 3 (6.3) | 83 (63.8) | 0.04 (0.01–0.13) | < 0.001 |