Pain pupillary index to prognosticate unfavorable outcome in comatose cardiac arrest patients

The prognostic role of the Pupillary Pain Index (PPI), derived from automated pupillometry, remains unknown in post-anoxic brain injury. Single-center retrospective study in adult comatose cardiac arrest (CA) patients. Quantitative PPI and Neurologic Pupil Index (NPi) were concomitantly recorded on day 1 and day 2 after CA. The primary outcome was to assess the prognostic value of PPI to predict 3-month unfavourable outcome (UO, defined as Cerebral Performance Category of 3–5). Secondary outcome was the agreement between PPI and NPi to predict unfavourable outcome. A total of 102 patients were included; patients with UO (n = 69, 68%) showed a lower NPi (4.2 [3.5–4.5] vs. 4.6 [4.3–4.7]; p