Cardiac arrest & resuscitation
Absolute blood levels and kinetics of neurofilament light (NFL) chains for neurological prognosis in comatose patients after cardiac arrest
Authors' conclusion
In comatose patients after CA, NFL levels at 24, 48 and 72 h could predict both unfavorable and favorable outcomes. Conversely, only the kinetic of NSE levels between 24 and 72 h after CA was associated with neurological outcome.
Study context
- Population
- Comatose patients after cardiac arrest (CA) with at least one blood NFL measurement, tertiary CA centre, April 2023–November 2024
- Participants
- 67 patients
- Comparison
- Unfavorable vs Favorable
- Outcome
- Neurological outcome by "best" mRS (mRS 0-3 = good outcome)
- Follow-up
- Within 3 months
Methodological detailssingle-centre, tertiary cardiac arrest centre
- Single-centre
- Tertiary cardiac arrest centre
Performance
As reported in the abstract
Blood NFL levels and prognostic accuracy · 24, 48 and 72 h
| Test or model | Value | AUC | Specificity (>250 pg/mL, poor outcome) | Sensitivity (>250 pg/mL, poor outcome) | Threshold for good outcome | Specificity (>383 pg/mL, poor outcome) | Sensitivity (>383 pg/mL, poor outcome) | Specificity (>510 pg/mL, poor outcome) | Sensitivity (>510 pg/mL, poor outcome) |
|---|---|---|---|---|---|---|---|---|---|
| Unfavorable outcome (24 h) | 256.0 (IQR 96.2–441.9) pg/mL | ||||||||
| Favorable outcome (24 h) | 37.9 (IQR 17.4–104.5) pg/mL | ||||||||
| Unfavorable outcome (48 h) | 1297.7 (IQR 137.6–3605.0) pg/mL | ||||||||
| Favorable outcome (48 h) | 36.4 (IQR 19.3–174.0) pg/mL | ||||||||
| Unfavorable outcome (72 h) | 1591.9 (IQR 350.6–4913.5) pg/mL | ||||||||
| Favorable outcome (72 h) | 49.3 (IQR 23.2–146.4) pg/mL | ||||||||
| NFL 24 h | 0.80 | 0.90 [0.75-0.90] | 0.51 [0.35-0.67] | < 82 pg/mL | |||||
| NFL 48 h | 0.88 | < 307 pg/mL | 0.94 [0.81-1.00] | 0.66 [0.50-0.81] | |||||
| NFL 72 h | 0.90 | < 459 pg/mL | 1.00 [1.00-1.00] | 0.74 [0.52-0.91] |
Value
Unfavorable outcome (24 h)256.0 (IQR 96.2–441.9) pg/mL
Favorable outcome (24 h)37.9 (IQR 17.4–104.5) pg/mL
Unfavorable outcome (48 h)1297.7 (IQR 137.6–3605.0) pg/mL
Favorable outcome (48 h)36.4 (IQR 19.3–174.0) pg/mL
Unfavorable outcome (72 h)1591.9 (IQR 350.6–4913.5) pg/mL
Favorable outcome (72 h)49.3 (IQR 23.2–146.4) pg/mL
NFL 24 h— not stated in the abstract
NFL 48 h— not stated in the abstract
NFL 72 h— not stated in the abstract
AUC
Unfavorable outcome (24 h)— not stated in the abstract
Favorable outcome (24 h)— not stated in the abstract
Unfavorable outcome (48 h)— not stated in the abstract
Favorable outcome (48 h)— not stated in the abstract
Unfavorable outcome (72 h)— not stated in the abstract
Favorable outcome (72 h)— not stated in the abstract
NFL 24 h0.80
NFL 48 h0.88
NFL 72 h0.90
Specificity (>250 pg/mL, poor outcome)
Unfavorable outcome (24 h)— not stated in the abstract
Favorable outcome (24 h)— not stated in the abstract
Unfavorable outcome (48 h)— not stated in the abstract
Favorable outcome (48 h)— not stated in the abstract
Unfavorable outcome (72 h)— not stated in the abstract
Favorable outcome (72 h)— not stated in the abstract
NFL 24 h0.90 [0.75-0.90]
NFL 48 h— not stated in the abstract
NFL 72 h— not stated in the abstract
Sensitivity (>250 pg/mL, poor outcome)
Unfavorable outcome (24 h)— not stated in the abstract
Favorable outcome (24 h)— not stated in the abstract
Unfavorable outcome (48 h)— not stated in the abstract
Favorable outcome (48 h)— not stated in the abstract
Unfavorable outcome (72 h)— not stated in the abstract
Favorable outcome (72 h)— not stated in the abstract
NFL 24 h0.51 [0.35-0.67]
NFL 48 h— not stated in the abstract
NFL 72 h— not stated in the abstract
Threshold for good outcome
Unfavorable outcome (24 h)— not stated in the abstract
Favorable outcome (24 h)— not stated in the abstract
Unfavorable outcome (48 h)— not stated in the abstract
Favorable outcome (48 h)— not stated in the abstract
Unfavorable outcome (72 h)— not stated in the abstract
Favorable outcome (72 h)— not stated in the abstract
NFL 24 h< 82 pg/mL
NFL 48 h< 307 pg/mL
NFL 72 h< 459 pg/mL
Specificity (>383 pg/mL, poor outcome)
Unfavorable outcome (24 h)— not stated in the abstract
Favorable outcome (24 h)— not stated in the abstract
Unfavorable outcome (48 h)— not stated in the abstract
Favorable outcome (48 h)— not stated in the abstract
Unfavorable outcome (72 h)— not stated in the abstract
Favorable outcome (72 h)— not stated in the abstract
NFL 24 h— not stated in the abstract
NFL 48 h0.94 [0.81-1.00]
NFL 72 h— not stated in the abstract
Sensitivity (>383 pg/mL, poor outcome)
Unfavorable outcome (24 h)— not stated in the abstract
Favorable outcome (24 h)— not stated in the abstract
Unfavorable outcome (48 h)— not stated in the abstract
Favorable outcome (48 h)— not stated in the abstract
Unfavorable outcome (72 h)— not stated in the abstract
Favorable outcome (72 h)— not stated in the abstract
NFL 24 h— not stated in the abstract
NFL 48 h0.66 [0.50-0.81]
NFL 72 h— not stated in the abstract
Specificity (>510 pg/mL, poor outcome)
Unfavorable outcome (24 h)— not stated in the abstract
Favorable outcome (24 h)— not stated in the abstract
Unfavorable outcome (48 h)— not stated in the abstract
Favorable outcome (48 h)— not stated in the abstract
Unfavorable outcome (72 h)— not stated in the abstract
Favorable outcome (72 h)— not stated in the abstract
NFL 24 h— not stated in the abstract
NFL 48 h— not stated in the abstract
NFL 72 h1.00 [1.00-1.00]
Sensitivity (>510 pg/mL, poor outcome)
Unfavorable outcome (24 h)— not stated in the abstract
Favorable outcome (24 h)— not stated in the abstract
Unfavorable outcome (48 h)— not stated in the abstract
Favorable outcome (48 h)— not stated in the abstract
Unfavorable outcome (72 h)— not stated in the abstract
Favorable outcome (72 h)— not stated in the abstract
NFL 24 h— not stated in the abstract
NFL 48 h— not stated in the abstract
NFL 72 h0.74 [0.52-0.91]
- Unfavorable outcome (24 h) vs Favorable outcome (24 h): P < 0.001
- Unfavorable outcome (48 h) vs Favorable outcome (48 h): P < 0.001
- Unfavorable outcome (72 h) vs Favorable outcome (72 h): P < 0.001
Further findings
| Outcome | NFL kinetic | NSE kinetic |
|---|---|---|
| Biomarker kinetics (24–72 h) | ||
| AUC | 0.50 | 0.92 |
Biomarker kinetics (24–72 h)
- NFL kinetic not associated with neurological outcome
Original publication
Absolute blood levels and kinetics of neurofilament light (NFL) chains for neurological prognosis in comatose patients after cardiac arrest. Ann Intensive Care. Published 30 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →