Acute cardiac care & resuscitation
Serum neurofilament light chain and multimodal neuroprognostication after cardiac arrest – A retrospective cohort study
Authors' conclusion
NFL (SIMOA) > 2000 pg/ml predicts poor neurological outcome with high specificity, while low concentrations strongly argue against severe HIE. Adding NFL to established neuroprognostication tests increases sensitivity of poor outcome prediction.
Study context
- Population
- Patients with serum NFL between 24–96 h after cardiac arrestpatients included
- Participants
- 152 patients
- Exposure
- Prognostic value of serum NFL in clinical routine compared to established prognostic tests
- Outcome
- Neurological outcome at hospital discharge
- Follow-up
- Hospital discharge
Main finding
As reported in the abstract
Discharged in vegetative state or comatose
10 patients
7%
Died before discharge
78
51%
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Poor outcome prediction, NFL > 2000 pg/ml | NFL sensitivity 53% (43-63%) · specificity 100% (94-100%) |
| Predictive accuracy of NFLSimilar to other neuroprognostic tests | NFL AUC 0.89 (range 0.84–0.94) |
Good outcome with NFL < 55 pg/ml
- Patients with NFL < 55 pg/ml with good outcome
- 69%
Additional poor outcome patients identified by NFL in head-to-head comparisons
- Additional poor outcome patients identified
- 16-41%
Baseline characteristics
- Median age
- 61 years
- Female
- 24%
Original publication
Serum neurofilament light chain and multimodal neuroprognostication after cardiac arrest – A retrospective cohort study. Resuscitation. Published 21 May 2025. doi:10.
Summarised from the published abstract; every number is checked against it