ArticleIntensive care medicine2021
Serum markers of brain injury can predict good neurological outcome after out-of-hospital cardiac arrest.
Article in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07782216 (Investigating the Significance of Protein Biomarkers During the Hyperacute Phase of Traumatic Brain Injury and Other CNS Conditions With Hypoxia/Hypoperfusion in Emergency and Prehospital Settings), which is not on this map. Cited by 55 papers, 7 of them syntheses that pooled it.
What it found
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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.
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.
Investigating the Significance of Protein Biomarkers During the Hyperacute Phase of Traumatic Brain Injury and Other CNS Conditions With Hypoxia/Hypoperfusion in Emergency and Prehospital Settings (CHARON)
Who cites it
55 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 6. Post-cardiac arrest care.Clinical and experimental emergency medicine · 2026Guideline
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Biospecimens and Biomarkers.Neurocritical care · 2024Pooled it
- Guidelines for Neuroprognostication in Comatose Adult Survivors of Cardiac Arrest.Neurocritical care · 2023Guideline
- Serum neurofilament light chain as a predictive marker of neurologic outcome after cardiac arrest: a meta-analysis.BMC cardiovascular disorders · 2023Pooled it
- Pooled it
- Prediction of good neurological outcome in comatose survivors of cardiac arrest: a systematic review.Intensive care medicine · 2022Pooled it
- Grey matter volume reduction and its association with brain-enriched blood biomarkers in out-of-hospital cardiac arrest survivors.Scientific reports · 2025Trial
- Quantification of blood-based neurovascular unit biomarkers: an analytical platform comparison study.Resuscitation plus · 2026Article
- Comparative efficacy of fluid resuscitation strategies in a rat model of traumatic cardiac arrest.Resuscitation plus · 2026Article
- Neuron-Specific Enolase for Neurological Prognostication After Cardiac Arrest in the Era of Targeted Temperature Management: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Early multimodal predictors of good neurological outcome in comatose patients after cardiac arrest: a prospective single-center cohort study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Early Prediction of Neurological Outcome After Cardiac Arrest-Rationale and Design of the Prospective International Observational EARLY-NEURO, a STEPCARE Substudy.Acta anaesthesiologica Scandinavica · 2026Observational
- Research advances on Cordyceps sinensis and its components in relation to omics biomarkers for the neurological disorders.Die Naturwissenschaften · 2026Review
- Differentiating Late Awakeners from Non-Awakeners in Comatose Cardiac Arrest Survivors: Diagnostic Value of Multimodal Monitoring in Patients with Indeterminate Prognosis.Diagnostics (Basel, Switzerland) · 2026Article
- The independent prognostic value of brain diffusion tensor imaging in comatose patients after cardiac arrest.Brain informatics · 2025Article
- Clinical use and reporting of neurofilament quantification in neurological disorders: A global overview.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Absolute blood levels and kinetics of neurofilament light (NFL) chains for neurological prognosis in comatose patients after cardiac arrest.Annals of intensive care · 2025Article
- Multimodal assessment of favorable neurological outcome using NSE levels and kinetics, EEG and SSEP in comatose patients after cardiac arrest.Critical care (London, England) · 2025Article
- Cerebrospinal Creatine Kinase BB Isoenzyme: A Biomarker for Predicting Outcome After Cardiac Arrest.Neurocritical care · 2025Article
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe majority of unconscious patients after cardiac arrest (CA) do not fulfill guideline criteria for a likely poor outcome, their prognosis is considered "indeterminate". We compared brain injury markers in blood for prediction of good outcome and for identifying false positive predictions of poor outcome as recommended by guidelines.
methodsRetrospective analysis of prospectively collected serum samples at 24, 48 and 72 h post arrest within the Target Temperature Management after out-of-hospital cardiac arrest (TTM)-trial. Clinically available markers neuron-specific enolase (NSE) and S100B, and novel markers neurofilament light chain (NFL), total tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) were analysed. Normal levels with a priori cutoffs specified by reference laboratories or defined from literature were used to predict good outcome (no to moderate disability, Cerebral Performance Category scale 1-2) at 6 months.
resultsSeven hundred and seventeen patients were included. Normal NFL, tau and GFAP had the highest sensitivities (97.2-98% of poor outcome patients had abnormal serum levels) and NPV (normal levels predicted good outcome in 87-95% of patients). Normal S100B and NSE predicted good outcome with NPV 76-82.2%. Normal NSE correctly identified 67/190 (35.3%) patients with good outcome among those classified as "indeterminate outcome" by guidelines. Five patients with single pathological prognostic findings despite normal biomarkers had good outcome.
conclusionLow levels of brain injury markers in blood are associated with good neurological outcome after CA. Incorporating biomarkers into neuroprognostication may help prevent premature withdrawal of life-sustaining therapy.
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