Cardiac arrest & resuscitation
Plasma neurofilament light is a predictor of neurological outcome 12 h after cardiac arrest
Authors' conclusion
The prognostic accuracy of NfL for predicting good and poor outcomes is excellent as early as 12 h after OHCA. NfL is less reliable for the prediction of outcome after IHCA.
Study context
- Population
- Adults admitted to intensive care after cardiac arrest
- Participants
- 428 adults
- Comparison
- Plasma neurofilament light (NfL) after out-of-hospital cardiac arrest (OHCA) vs in-hospital cardiac arrest (IHCA)
- OHCAn = 328
- IHCAn = 100
- Outcome
- Prediction of poor neurological outcome (Cerebral Performance Category (CPC) 3-5 vs good CPC 1-2) by plasma NfL, AUROC
- Follow-up
- Two to six months
Methodological detailsobservational multicentre cohort study, retrospective biomarker analysis, NfL retrospectively analysed in plasma collected on ICU admission, 12 and 48 h after cardiac arrest
- Observational multicentre cohort study
- Retrospective biomarker analysis
- NfL retrospectively analysed in plasma collected on ICU admission, 12 and 48 h after cardiac arrest
Performance
As reported in the abstract
Prognostic performance of NfL (AUROC) at 12 and 48 h · 12 and 48 h after cardiac arrest
| Test or model | AUROC 12 h | AUROC 48 h |
|---|---|---|
| OHCA | 0.93 | 0.97 |
| IHCA | 0.81 | 0.86 |
AUROC 12 h
OHCA0.93
IHCA0.81
AUROC 48 h
OHCA0.97
IHCA0.86
- IHCA vs OHCA: P ≤ 0.03 — lower predictive ability after IHCA at 12 and 48 h
Further findings
Poor outcome rate · two to six months
| Outcome | OHCA | IHCA |
|---|---|---|
| AUROC on ICU admission · admission to intensive care | ||
| AUROC | 0.77 | 0.67 |
- High NfL predicting poor outcome at 95% specificity, OHCA (subgroup) · 12 and 48 h
- 70 · sensitivity 12 h · sensitivity 48 h 89%
- Low NfL predicting good outcome at 95% sensitivity, OHCA (subgroup) · 12 and 48 h
- 71 · specificity 12 h · specificity 48 h 74% · NPV 12 h 86 · NPV 48 h 88%
Original publication
Plasma neurofilament light is a predictor of neurological outcome 12 h after cardiac arrest. Crit Care. Published 24 February 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →