Evidence map›Paper›PMID 33472689›Full record

Observational studyCritical care (London, England)2021

Serum neurofilament measurement improves clinical risk scores for outcome prediction after cardiac arrest: results of a prospective study.

Sabina Hunziker, Adrian Quinto, Maja Ramin-Wright, Christoph Becker, Katharina Beck, Alessia Vincent, Kai Tisljar, Giulio Disanto, Pascal Benkert, David Leppert and 5 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  7. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Sabina HunzikerIntensive Care Unit, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland. Sabina.Hunziker@usb.ch.ORCID 0000-0003-3648-3609
Adrian Quinto *Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031, Basel, Switzerland.
Maja Ramin-Wright *Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031, Basel, Switzerland.
Christoph BeckerMedical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031, Basel, Switzerland.
Katharina BeckMedical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031, Basel, Switzerland.
Alessia VincentMedical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031, Basel, Switzerland.
Kai TisljarIntensive Care Unit, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Giulio DisantoMedical Faculty, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland.
Pascal BenkertClinical Trial Unit Basel, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
David LeppertMedical Faculty, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland.
Hans ParggerIntensive Care Unit, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Stephan MarschIntensive Care Unit, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Raoul SutterIntensive Care Unit, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Nils PetersMedical Faculty, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland.
Jens KuhleMedical Faculty, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland.

Funding

Gottfried und Julia Bangerter-Rhyner-Stiftung 8472/HEG-DSVSchweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 10001C_192850/1Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 10531C_182422Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 320030_189140/1
6 · The paper itself

Abstract

backgroundA recent study found serum neurofilament light chain (NfL) levels to be strongly associated with poor neurological outcome in patients after cardiac arrest. Our aim was to confirm these findings in an independent validation study and to investigate whether NfL improves the prognostic value of two cardiac arrest-specific risk scores.

methodsThis prospective, single-center study included 164 consecutive adult after out-of-hospital cardiac arrest (OHCA) patients upon intensive care unit admission. We calculated two clinical risk scores (OHCA, CAHP) and measured NfL on admission within the first 24 h using the single molecule array NF-light

resultsPoor neurological outcome (CPC > 3) was found in 60% (98/164) of patients, with 55% (91/164) dying within 30 days of hospitalization. Compared to patients with favorable outcome, NfL was 14-times higher in patients with poor neurological outcome (685 ± 1787 vs. 49 ± 111 pg/mL), with an adjusted odds ratio of 3.4 (95% CI 2.1 to 5.6, p < 0.001) and an area under the curve (AUC) of 0.82. Adding NfL to the clinical risk scores significantly improved discrimination of both the OHCA score (from AUC 0.82 to 0.89, p < 0.001) and CAHP score (from AUC 0.89 to 0.92, p < 0.05). Adding NfL to both scores also resulted in significant improvement in reclassification statistics with a Net Reclassification Index (NRI) of 0.58 (p < 0.001) for OHCA and 0.83 (p < 0.001) for CAHP.

conclusionsAdmission NfL was a strong outcome predictor and significantly improved two clinical risk scores regarding prognostication of neurological outcome in patients after cardiac arrest. When confirmed in future outcome studies, admission NfL should be considered as a standard laboratory measures in the evaluation of OHCA patients.

Indexed as

Severity of Illness IndexAgedArea Under CurveBiomarkersFemaleHeart ArrestHumansMaleMiddle AgedNeurofilament ProteinsOdds RatioPrognosisProspective StudiesRisk AssessmentROC CurveSwitzerlandBiomarkersNeurofilament ProteinsCAHPCardiac arrestCardiopulmonary resuscitationOHCAPrognosisSerum neurofilament

Identifiers

PMID33472689
PMCPMC7819224

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.