Crit Care: Serum neural wire assays improve clinical risk scores for outcome prediction in patients with cardiac arrest

A recent study found that serum nerve wire light chain (NfL) levels in patients with cardiac arrest were closely associated with poor nerve prognosis.
, researchers aim to confirm these findings in an independent validation study and explore whether NfL can improve the prognostic value of two cardiac arrest-specific risk scores, according to a recent study published in The Journal of Critical Medicine.
the prospective, single-center study included 164 adult patients with continuous out-of-hospital cardiac arrest (OHCA).
the researchers calculated two clinical risk scores (OHCA and CAHP) and measured the subjects' NfL levels within 24 hours of hospitalization using a single-molecule array NF-light experiment.
the main endpoint of the study was neurological outcomes at discharge from the hospital, which were assessed on the basis of the Brain Function Category (CPC) score.
60% (98/164) of patients had neurological adverse outcomes (CPC-gt;3), of which 55% (91/164) died within 30 days of hospitalization.
NfL levels were 14 times higher in patients with poor neurological outcomes (685±1 787 vs. 49±111 pg/mL) compared to patients with good outcomes, with a corrected ratio of 3.4 (95% CI of 2.1 to 5.6, p.lt; 0.001) and a curved area (AUC) of 0.82.
addition of NfL to the clinical risk score can significantly improve the effectiveness of OHCA scores (AUC from 0.82 to 0.89, p.lt;0.001) and CAHP scores (AUC from 0.89 to 0.92, p.lt;0.05).
addition of NfL to the two scores can also significantly improve the reclassification statistics, with ohCA's net reclassification index (NRI) at 0.58 (p.lt;0.001) and CAHP's net reclassification index (NRI) at 0.83 (p.lt;0.001).
, it can be seen that hospitalization NfL is a powerful prognostic indicator that can significantly improve the clinical risk score of the nervous system prognostics of two cardiac arrest patients.