Observational studyEBioMedicine2022
Plasma neurofilament light chain protein as a predictor of days in delirium and deep sedation, mortality and length of stay in critically ill patients.
Observational study in EBioMedicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Perioperative neurofilament light chain and glial fibrillary acidic protein as biomarkers of postoperative delirium: a systematic review and meta-analysis.BMC geriatrics · 2026Pooled it
- Mechanisms underlying neurocognitive dysfunction following critical illness: a systematic review.Anaesthesia · 2025Pooled it
- Effects of remimazolam vs. propofol on plasma neurofilament light chain and postoperative delirium in frail elderly patients undergoing major non-cardiac surgery: a prospective, randomized, assessor-blinded controlled trial.BMC anesthesiology · 2026Trial
- Improving the Outcome of Brain-Injured Patients by Non-Continuous Feeding to Prevent Dysbiosis.Nutrients · 2026Review
- CSF neurofilament light chain concentration in patients with delirium following hip fracture: a multicenter prospective study.BMC geriatrics · 2026Observational
- Blood-based biomarkers and delirium in critically ill adults in the ICU: a systematic review.Intensive care medicine experimental · 2026Review
- Long-chain polyunsaturated fatty acid lipid and oxylipin alterations in postoperative delirium after cardiac surgery.Journal of lipid research · 2026Article
- Delirium Management in Critical Care: Are We Moving Forward or Still Treading Water?Medical sciences (Basel, Switzerland) · 2025Review
- Unravelling the complex inflammatory landscape of COVID-19 infection: a pathway to biomarkers identification in infection-associated delirium in the ICU.Intensive care medicine experimental · 2025Article
- Potential therapeutic benefit of exogenous ketone ester administration in delirium: a narrative review.Critical care (London, England) · 2025Review
- Serum biomarkers of delirium in critical illness: a systematic review of mechanistic and diagnostic evidence.Intensive care medicine experimental · 2025Review
- Association of Central Nervous System-Related Biomarkers With Hospital Delirium in Patients With Respiratory Failure in the ICU.CHEST critical care · 2025Article
- Delirium pathophysiology in cancer: neurofilament light chain biomarker - narrative review.BMJ supportive & palliative care · 2025Review
- Neurofilament-Light Chain and Glial Fibrillary Acidic Protein as Blood-Based Delirium Risk Markers: A Multicohort Study.Aging and disease · 2025Article
- Increased cell-free DNA in CSF and serum of hip fracture patients with delirium.Brain communications · 2025Article
- Sepsis-associated encephalopathy: Mechanisms, Diagnosis, and Treatments update.International journal of biological sciences · 2025Review
- Commentary: The impact of autoimmune diseases on delirium risk in critically ill patients: a propensity score matching multicenter analysis.Frontiers in medicine · 2025Article
- Persistent delirium is associated with cerebrospinal fluid markers of neuronal injury.Brain communications · 2024Article
- Serum total tau, neurofilament light, and glial fibrillary acidic protein are associated with mortality in a population study.Journal of the American Geriatrics Society · 2024Article
- Neurofilament light chains to assess sepsis-associated encephalopathy: Are we on the track toward clinical implementation?Critical care (London, England) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 7 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelirium predicts poor outcomes, however identifying patients with the worst outcomes is challenging. Plasma neurofilament light protein (NfL) is a sensitive indicator of neuronal damage. We undertook an exploratory observational study to determine the association between plasma NfL and delirium in the critically ill.
methodsMoDUS was a randomised placebo-controlled delirium trial of simvastatin done in an UK adult general ICU. We measured NfL levels in plasma samples using a Single molecule array (Simoa) platform. We explored associations between patient's plasma NfL levels and number of delirium days, and clinical outcomes. The control group for baseline NfL were preoperative patients undergoing major surgery.
findingsThe majority of critically ill patients already had a high NfL level on admission. Patients with higher plasma NfL levels at days one and three spent more days in delirium or deep sedation. Patients with zero or one day in delirium or deep sedation had day one mean concentrations of 37.8 pg/ml (SD 32.6) compared with 96.5 pg/ml (SD 106.1)) for patients with two days or more, p-value 0.002 linear mixed effects model. Survivors discharged before 14 days had lower mean plasma NfL concentrations compared to those with longer hospital stays and/or who died within six months. The area under ROC curve for predicting death within six months using day one NfL was 0.81 (0.7,0.9).
interpretationMeasurement of plasma NfL within three days of admission may be useful to identify those patients with worse clinical outcomes, and as an enrichment strategy for future delirium interventional trials in the critically ill.
fundingAlzheimer's Society UK, UK Dementia Research Institute.
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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.