Observational studyCritical care (London, England)2023
Plasma neurofilament light is a predictor of neurological outcome 12 h after cardiac arrest.
Observational study in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 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
20 citing papers in PubMed, 3 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
- 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
- Serial plasma proenkephalin A 119-159 and dipeptidyl peptidase 3 after cardiac arrest: association with long-term neurological outcome.Resuscitation plus · 2026Article
- Neurofilament light chain for assessment of brain injury in four porcine cardiac arrest models.Resuscitation plus · 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
- [Neurological prognosis after cardiac arrest and resuscitation].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- Hypothermia after Cardiac Arrest in Large Animals (HACA-LA): a randomized controlled experimental study.Intensive care medicine experimental · 2025Article
- Combining plasma p-tauAlzheimer's & dementia : the journal of the Alzheimer's Association · 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
- Personalized neuron-specific enolase level based on EEG pattern for prediction of poor outcome after cardiac arrest.Annals of intensive care · 2025Article
- Multi-Modal Assessment of Cerebral Hemodynamics in Resuscitated Out-of-Hospital Cardiac Arrest Patients: A Case-Series.Life (Basel, Switzerland) · 2024Article
- Neurofilaments as biomarkers in neurological disorders - towards clinical application.Nature reviews. Neurology · 2024Review
- Plasma glial fibrillary acidic protein and tau: predictors of neurological outcome after cardiac arrest.Critical care (London, England) · 2024Observational
- Wolf Creek XVII Part 8: Neuroprotection.Resuscitation plus · 2024Review
- Plasma biomarkers for brain injury in extracorporeal membrane oxygenation.Acute and critical care · 2023Article
- Biomarkers in Cardiac Arrest: A Narrative Review.Therapeutic advances in pulmonary and critical care medicineReview
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies have reported high prognostic accuracy of circulating neurofilament light (NfL) at 24-72 h after out-of-hospital cardiac arrest (OHCA), but performance at earlier time points and after in-hospital cardiac arrest (IHCA) is less investigated. We aimed to assess plasma NfL during the first 48 h after OHCA and IHCA to predict long-term outcomes.
methodsObservational multicentre cohort study in adults admitted to intensive care after cardiac arrest. NfL was retrospectively analysed in plasma collected on admission to intensive care, 12 and 48 h after cardiac arrest. The outcome was assessed at two to six months using the Cerebral Performance Category (CPC) scale, where CPC 1-2 was considered a good outcome and CPC 3-5 a poor outcome. Predictive performance was measured with the area under the receiver operating characteristic curve (AUROC).
resultsOf 428 patients, 328 (77%) suffered OHCA and 100 (23%) IHCA. Poor outcome was found in 68% of OHCA and 55% of IHCA patients. The overall prognostic performance of NfL was excellent at 12 and 48 h after OHCA, with AUROCs of 0.93 and 0.97, respectively. The predictive ability was lower after IHCA than OHCA at 12 and 48 h, with AUROCs of 0.81 and 0.86 (p ≤ 0.03). AUROCs on admission were 0.77 and 0.67 after OHCA and IHCA, respectively. At 12 and 48 h after OHCA, high NfL levels predicted poor outcome at 95% specificity with 70 and 89% sensitivity, while low NfL levels predicted good outcome at 95% sensitivity with 71 and 74% specificity and negative predictive values of 86 and 88%.
conclusionsThe prognostic accuracy of NfL for predicting good and poor outcomes is excellent as early as 12 h after OHCA. NfL is less reliable for the prediction of outcome after IHCA.
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