SynthesisJAMA neurology2022
Neurologic Prognostication After Cardiac Arrest Using Brain Biomarkers: A Systematic Review and Meta-analysis.
Synthesis in JAMA neurology, 2022. 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 57 papers, 2 of them syntheses that pooled 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.
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
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 107 citations in OpenAlex.
- The utility of brain biomarkers in predicting survival and neurological outcomes in pediatric patients after cardiac arrest: A systematic review and meta-analysis.Cardiology journal · 2025Pooled it
- Pooled it
- Grey matter volume reduction and its association with brain-enriched blood biomarkers in out-of-hospital cardiac arrest survivors.Scientific reports · 2025Trial
- Neurofilament light chain for prognostication after cardiac arrest-first steps towards validation.Critical care (London, England) · 2025Trial
- Prehospital high-dose methylprednisolone in resuscitated out-of-hospital cardiac arrest patients (STEROHCA): a randomized clinical trial.Intensive care medicine · 2023Trial
- Brain edema progression rate on serial CT predicts neurological outcome after cardiac arrest: a region-specific biomarker of hypoxic-ischemic brain injury.Resuscitation plus · 2026Article
- Quantification of blood-based neurovascular unit biomarkers: an analytical platform comparison study.Resuscitation plus · 2026Article
- Observational study: Temporal dynamics of lipoprotein(a) after out-of-hospital cardiac arrest: The Biobank Working Group.Resuscitation plus · 2026Article
- Insights into the pathophysiology of stroke-heart syndrome: a review of recent literature and clinical trials to illuminate promising therapeutic strategies.Annals of medicine and surgery (2012) · 2026Article
- Moderate hypoxaemia and cognitive impairment in individuals with cigarette smoke exposure.ERJ open research · 2026Article
- Temporal trends in post-cardiac arrest brain injury research: a bibliometric analysis of evolving priorities and translation gaps.Resuscitation plus · 2026Article
- Plasma Biomarkers of Brain Injury in Critically Ill Children Receiving Extracorporeal Membrane Oxygenation.JAMA pediatrics · 2026Observational
- Observational
- Detection of elevated levels of taurine and creatine in the brain of hypoxic-ischemic newborn rat using a magnetic resonance spin echo full intensity acquired localization sequence.Translational pediatrics · 2026Article
- Metabolism-Mediated Regulation of Brain-Heart Interactions.International journal of molecular sciences · 2026Review
- White matter injury after brain ischemia.Experimental neurology · 2026Review
- Bioinformatics Analysis of ZDHHC-protein Acyltransferase for Predicting the Rupture of Aneurysmal Subarachnoid Hemorrhage.Current neurovascular research · 2026Article
- Brain neurovascular unit biomarkers: a hypothesis-driven paradigm to advance understanding of post-cardiac arrest cerebral injury.Annals of intensive care · 2026Review
- Summary of best evidence for targeted body temperature management in patients with severe neurological illness.Frontiers in medicine · 2026Review
- Correlation of blood biomarkers with microstructural brain injury in survivors of out-of-hospital cardiac arrest.Brain communications · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceBrain injury biomarkers released into circulation from the injured neurovascular unit are important prognostic tools in patients with cardiac arrest who develop hypoxic ischemic brain injury (HIBI) after return of spontaneous circulation (ROSC).
objectiveTo assess the neuroprognostic utility of bloodborne brain injury biomarkers in patients with cardiac arrest with HIBI. DATA SOURCES: Studies in electronic databases from inception to September 15, 2021. These databases included MEDLINE, Embase, Evidence-Based Medicine Reviews, CINAHL, Cochrane Database of Systematic Reviews, and the World Health Organization Global Health Library. STUDY SELECTION: Articles included in this systmatic review and meta-analysis were independently assessed by 2 reviewers. We included studies that investigated neuron-specific enolase, S100 calcium-binding protein β, glial fibrillary acidic protein, neurofilament light, tau, or ubiquitin carboxyl hydrolase L1 in patients with cardiac arrest aged 18 years and older for neurologic prognostication. We excluded studies that did not (1) dichotomize neurologic outcome as favorable vs unfavorable, (2) specify the timing of blood sampling or outcome determination, or (3) report diagnostic test accuracy or biomarker concentration. DATA EXTRACTION AND SYNTHESIS: Data on the study design, inclusion and exclusion criteria, brain biomarkers levels, diagnostic test accuracy, and neurologic outcome were recorded. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. MAIN OUTCOMES AND MEASURES: Summary receiver operating characteristic curve analysis was used to calculate the area under the curve, sensitivity, specificity, and optimal thresholds for each biomarker. Risk of bias and concerns of applicability were assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
resultsWe identified 2953 studies, of which 86 studies with 10 567 patients (7777 men [73.6] and 2790 women [26.4]; pooled mean [SD] age, 62.8 [10.2] years) were included. Biomarker analysis at 48 hours after ROSC demonstrated that neurofilament light had the highest predictive value for unfavorable neurologic outcome, with an area under the curve of 0.92 (95% CI, 0.84-0.97). Subgroup analyses of patients treated with targeted temperature management and those who specifically had an out-of-hospital cardiac arrest showed similar results (targeted temperature management, 0.92 [95% CI, 0.86-0.95] and out-of-hospital cardiac arrest, 0.93 [95% CI, 0.86-0.97]). CONCLUSIONS AND RELEVANCE: Neurofilament light, which reflects white matter damage and axonal injury, yielded the highest accuracy in predicting neurologic outcome in patients with HIBI at 48 hours after ROSC.
trial registrationPROSPERO Identifier: CRD42020157366.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.