Association of prehospital pupillary diameter with return of spontaneous circulation and neurological outcome after out-of-hospital cardiac arrest: A multicenter retrospective analysis

Prehospital pupillary diameter is independently associated with both ROSC and 30-day neurological outcome. Although extreme dilation (≥7-8 mm) provides a highly specific marker of futility, low sensitivity precludes its use as a stand-alone criterion. Pupillary assessment may nonetheless contribute, in combination with other prehospital indicators, to a multimodal framework for early decision-making.