- Among unconscious patients with out-of-hospital cardiac arrest, the serum neurofilament light chain (NFL) level at 24 hours predicted poor 6-month neurologic outcome.
Why this matters
- Predicting neurologic outcome in this population remains challenging.
- 50.2% of patients had poor neurologic outcome at 6 months.
- Median serum NFL level higher in patients with poor vs good outcome:
- 24 hours (1426 vs 37 pg/mL; P<.001>
- 48 hours (3240 vs 46 pg/mL; P<.001>
- 72 hours (3344 vs 54 pg/mL; P<.001>
- Overall performance (area under curve, 0.94-0.95);
- Sensitivity and specificity (e.g., 69% and 98% at 24 hours).
- International prospective cohort study using data from randomized trial among 717 unconscious patients with out-of-hospital cardiac arrest, presumed cardiac origin.
- Serum NFL levels measured with ultrasensitive immunoassay.
- Main outcome: 6-month poor neurologic outcome (Cerebral Performance Category Scale category 3, 4, or 5).
- Funding: Swedish Research Council; others.
- Assay not widely available.
- External validation, establishment of reference ranges needed.