Serum neurofilament light chain as a predictive marker of neurologic outcome after cardiac arrest: a meta-analysis

Abstract

Objective Recently, an increasing number of studies have suggested using serum neurofilament light (NfL) chain to predict the neurologic outcome after cardiac arrest. However, the predictive ability of this approach remains inconclusive. Meta-analysis was performed on related studies to assess the ability of serum NfL to predict the neurologic outcome after cardiac arrest. Materials and methods PubMed, ScienceDirect and Embase were systematically searched from the date of their inception until June 2022. Data were extracted to calculate the area under the receiver operating characteristic curve (AUC), the sensitivity, the specificity and the publication bias to evaluate the predictive power of serum NfL using Stata 14.0. Results Nine studies were included in the present meta-analysis. Seven studies involving 1296 participants reported serum NfL 24 h post arrest for predicting the neurological outcome, and the AUC was 0.92 (77% sensitivity and 96% specificity). Seven studies involving 1020 participants reported serum NfL 48 h post arrest for predicting the neurological outcome, and the AUC was 0.94 (78% sensitivity and 98% specificity). Four studies involving 804 participants reported serum NfL 72 h post arrest for predicting the neurological outcome, and the AUC was 0.96 (90% sensitivity and 98% specificity). No significant publication bias was observed among the included studies. Conclusion The present meta-analysis results support the potential use of serum NfL as an early biomarker of neurologic outcome, especially 72 h post arrest.

Predictive Performance of Neuron-Specific Enolase (NSE) for Survival after Resuscitation from Cardiac Arrest: A Systematic Review and Meta-Analysis

“…NfL was also the subject of a recently published meta-analysis that demonstrated its particular utility in predicting neurological statuses when measured 72 h after cardiac arrest. Based on the results obtained from 804 patients, the sensitivity and specificity of NfL after 72 h were determined to be 90% and 98%, respectively [116]. The usefulness of this biomarker was also demonstrated in another meta-analysis among patients with concussions [117].…”

Postresuscitation management

“…Recent studies have underscored the significance of exploring novel biomarkers, such as neurofilament light chain, which may exhibit superior accuracy compared to NSE for predicting neurological outcomes in this context [73]. Additionally, the application of deep learning network analysis to EEG has demonstrated exceptional predictive performance in this domain [74], offering the potential for automated EEG analysis to furnish a more objective and precise evaluation of specific prognostic patterns among cardiac arrest patients.…”