Longitudinal serum neurofilament light kinetics in post-anoxic encephalopathy

Serum neurofilament light (sNfL) is a promising marker of outcome after cardiac arrest, but its kinetics are unclear. We prospectively measured sNfL concentrations in 62 patients at 0, 1, 3, 5, 7 and 10 days after cardiac arrest. Survivors and non-survivors had similar sNfL at admission (14.2 [8.6-21.9] vs. 22.5 [14.2-46.9] pg/mL) but largely different at 24 h (16.4 [10.2-293] vs. 464.3 [151.8-1658.2], respectively). The AUC for sNfL concentrations predicting death was above 0.95 from Day 1 to 10 (highest on Day 3). Late sNfL measurements may exert prognostic value, especially when early samples are unavailable or prognosis remains unclear.

Automated summary

Serum neurofilament light (sNfL) is a promising marker for predicting the outcome of cardiac arrest. The study found that sNfL levels were similar between survivors and non-survivors upon admission, but significant differences were observed after 24 hours. sNfL concentrations showed high predictive value for death, especially when early samples were unavailable or prognosis remained uncertain.