Universität zu Köln

Adler, Christoph, Onur, Oezguer A., Braumann, Simon, Gramespacher, Hannes ORCID: 0000-0002-9980-4978, Bittner, Stefan, Falk, Steffen, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Baldus, Stephan and Warnke, Clemens ORCID: 0000-0002-3510-9255 (2022). Absolute serum neurofilament light chain levels and its early kinetics predict brain injury after out-of-hospital cardiac arrest. J. Neurol., 269 (3). S. 1530 - 1538. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-1459

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Abstract

Objectives To test if the early kinetics of neurofilament light (NFL) in blood adds to the absolute values of NFL in the prediction of outcome, and to evaluate if NFL can discriminate individuals with severe hypoxic-ischemic brain injury (sHIBI) from those with other causes of poor outcome after out-of-hospital cardiac arrest (OHCA). Design and setting Monocentric retrospective study involving individuals following non-traumatic OHCA between April 2014 and April 2016. NFL concentrations were determined on a SiMoA HD-1 device using NF-Light Advantage Kits. Participants Of 73 patients screened, 53 had serum samples available for NFL measurement at three timepoints (after 3, 24, and 48 h of admission). Of these 53 individuals, 43.4% had poor neurologic outcome at discharge as assessed by Glasgow-Pittsburgh cerebral performance categories, and, according to a current prognostication algorithm, poor outcome due to sHIBI in 20.7%. Main outcome measure Blood NFL and its early kinetics for prognostication of outcome and prediction of sHIBI after OHCA. Results An absolute NFL > 508.6 pg/ml 48 h after admission, or a change in NFL > 494 pg/ml compared with an early baseline value predicted outcome, and discriminated severe sHIBI from other causes of unfavorable outcome after OHCA with high sensitivity (100%, 95%CI 70.0-100%) and specificity (91.7%, 95%CI 62.5-100%). Conclusions Not only absolute values of NFL, but also early changes in NFL predict the outcome following OHCA, and may differentiate sHIBI from other causes of poor outcome after OHCA with high sensitivity and specificity. Our study adds to published data, overall corroborating that NFL measured in blood should be implemented in prognostication algorithms used in clinical routine.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Adler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Onur, Oezguer A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Braumann, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Gramespacher, Hannes UNSPECIFIED orcid.org/0000-0002-9980-4978 UNSPECIFIED Bittner, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Falk, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Warnke, Clemens UNSPECIFIED orcid.org/0000-0002-3510-9255 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-586029
DOI:	10.1007/s00415-021-10722-3
Journal or Publication Title:	J. Neurol.
Volume:	269
Number:	3
Page Range:	S. 1530 - 1538
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1432-1459
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NEURON-SPECIFIC ENOLASE; EUROPEAN RESUSCITATION COUNCIL; INTENSIVE-CARE; LIFE; GUIDELINES; WITHDRAWAL; END Multiple languages Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58602