Serum neurofilament light chain and multimodal neuroprognostication after cardiac arrest – A retrospective cohort study
Authors' conclusion
NFL (SIMOA) > 2000 pg/ml predicts poor neurological outcome with high specificity, while low concentrations strongly argue against severe HIE. Adding NFL to established neuroprognostication tests increases sensitivity of poor outcome prediction.
Study context
- Population
- Patients after cardiac arrest with serum NFL measured between 24–96 h
- Participants
- 152 patients
- Exposure
- Serum NFL vs neuron specific enolase (NSE), EEG, SSEP and head computed tomography (CT) for neuroprognostication
- Outcome
- Prognostic performance for poor neurological outcome (CPC 4-5) vs good (CPC 1-3)
- Follow-up
- Hospital discharge
Methodological detailsmonocentric, observational
- Monocentric
- Observational
Main finding
As reported in the abstract
Poor neurological outcome prediction, NFL > 2000 pg/ml
| Group | Sensitivity | Specificity | AUC |
|---|---|---|---|
| NFL | 53% (43-63%) | 100% (94-100%) | 0.89, 0.84-0.94 |
NFL
Sensitivity53% (43-63%)
Specificity100% (94-100%)
AUC0.89, 0.84-0.94
Observational data: associations, not effects.
Further findings
Good outcome with NFL < 55 pg/ml
- Patients with NFL < 55 pg/ml with good outcome
- 69%
Additional poor outcome patients identified by NFL in head-to-head comparisons with other tests
- Additional poor outcome patients identified
- 16-41%
Outcome at discharge · hospital discharge
- Vegetative state or comatose
- 10 (7%)
- Died before discharge
- 78 (51%)
Original publication
Serum neurofilament light chain and multimodal neuroprognostication after cardiac arrest – A retrospective cohort study. Resuscitation. Published 21 May 2025. doi:10.
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