Increased Hospital Mortality in Patients with Bedside Hippus - 20/08/11
Requests for reprints should be addressed to Eric G. Neilson, MD, Hugh Jackson Morgan Professor of Medicine and Cell and Developmental Biology, Chairman, Department of Medicine D-3100 MCN, Vanderbilt University School of Medicine, Nashville, TN 37232-2358.Abstract |
Background |
Hippus is a prominent, repetitive oscillation of the pupils. Although regarded by some as a normal variant of pupillary unrest, the clinical importance of hippus has not been investigated systematically in hospitalized patients.
Methods |
We conducted a retrospective cohort study of 117 hospitalized patients demonstrating hippus. To mitigate observer bias, 486 control patients were selected using 2 adjacent admissions by the same attending physician before and after each index case. The primary outcomes were mortality during the admission and within 30 days of discharge.
Results |
Patients with bedside hippus were more likely to die within 30 days of observation (P <.00005). Independent risk factors for death by 30 days were altered mental status (odds ratio [OR] 4.11; 95% confidence interval [CI], 2.05-8.25, P <.001), hippus (OR 2.99; 95% CI, 1.46-6.11, P = .003), cirrhosis (P = .029), and renal disease (P = .054); angiotensin-system inhibitors were protective (P = .012). Patients with hippus were more likely to have altered mental status (OR 11.23; 95% CI, 6.27-20.09, P <.001), a history of trauma (OR 3.76; 95% CI, 1.65-8.59, P = .002), cirrhosis (P = .038), renal disease (P = .051), and a history of using iron supplements (P = .016).
Conclusion |
The recognition of hippus in hospitalized patients is a clinically important predictor of early mortality.
El texto completo de este artículo está disponible en PDF.Keywords : Altered mental status, Cirrhosis, Hippus, Hospital mortality, Renal disease, Trauma
Esquema
| Dr Denny was supported by National Institutes of Health grant T15 LM007450-04. There are no conflicts of interest to disclose. |
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| All authors had full access to the data and take responsibility for the integrity of the data and accuracy of the data analysis. |
Vol 121 - N° 3
P. 239-245 - mars 2008 Regresar al número
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