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Sökning: onr:"swepub:oai:lup.lub.lu.se:bcd6b4f3-aef7-4b35-b918-226c75b545f9" > Serum Neurofilament...

  • Moseby-Knappe, MarionLund University,Lunds universitet,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital (författare)

Serum Neurofilament Light Chain for Prognosis of Outcome after Cardiac Arrest

  • Artikel/kapitelEngelska2019

Förlag, utgivningsår, omfång ...

  • American Medical Association (AMA),2019

Nummerbeteckningar

  • LIBRIS-ID:oai:lup.lub.lu.se:bcd6b4f3-aef7-4b35-b918-226c75b545f9
  • https://lup.lub.lu.se/record/bcd6b4f3-aef7-4b35-b918-226c75b545f9URI
  • https://doi.org/10.1001/jamaneurol.2018.3223DOI
  • https://gup.ub.gu.se/publication/275506URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:art swepub-publicationtype
  • Ämneskategori:ref swepub-contenttype

Anmärkningar

  • Importance: Prognostication of neurologic outcome after cardiac arrest is an important but challenging aspect of patient therapy management in critical care units. Objective: To determine whether serum neurofilament light chain (NFL) levels can be used for prognostication of neurologic outcome after cardiac arrest. Design, Setting and Participants: Prospective clinical biobank study of data from the randomized Target Temperature Management After Cardiac Arrest trial, an international, multicenter study with 29 participating sites. Patients were included between November 11, 2010, and January 10, 2013. Serum NFL levels were analyzed between August 1 and August 23, 2017, after trial completion. A total of 782 unconscious patients with out-of-hospital cardiac arrest of presumed cardiac origin were eligible. Exposures: Serum NFL concentrations analyzed at 24, 48, and 72 hours after cardiac arrest with an ultrasensitive immunoassay. Main Outcomes and Measures: Poor neurologic outcome at 6-month follow-up, defined according to the Cerebral Performance Category Scale as cerebral performance category 3 (severe cerebral disability), 4 (coma), or 5 (brain death). Results: Of 782 eligible patients, 65 patients (8.3%) were excluded because of issues with aliquoting, missing sampling, missing outcome, or transport problems of samples. Of the 717 patients included (91.7%), 580 were men (80.9%) and median (interquartile range [IQR]) age was 65 (56-73) years. A total of 360 patients (50.2%) had poor neurologic outcome at 6 months. Median (IQR) serum NFL level was significantly increased in the patients with poor outcome vs good outcome at 24 hours (1426 [299-3577] vs 37 [20-70] pg/mL), 48 hours (3240 [623-8271] vs 46 [26-101] pg/mL), and 72 hours (3344 [845-7838] vs 54 [30-122] pg/mL) (P <.001 at all time points), with high overall performance (area under the curve, 0.94-0.95) and high sensitivities at high specificities (eg, 69% sensitivity with 98% specificity at 24 hours). Serum NFL levels had significantly greater performance than the other biochemical serum markers (ie, tau, neuron-specific enolase, and S100). At comparable specificities, serum NFL levels had greater sensitivity for poor outcome compared with routine electroencephalogram, somatosensory-evoked potentials, head computed tomography, and both pupillary and corneal reflexes (ranging from 29.2% to 49.0% greater for serum NFL level). Conclusions and Relevance: Findings from this study suggest that the serum NFL level is a highly predictive marker of long-term poor neurologic outcome at 24 hours after cardiac arrest and may be a useful complement to currently available neurologic prognostication methods.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Mattsson, NiklasLund University,Lunds universitet,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Lund University Research Groups(Swepub:lu)med-nmn (författare)
  • Nielsen, NiklasLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Helsingborg Hospital(Swepub:lu)med-nni (författare)
  • Zetterberg, HenrikGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry(Swepub:gu)xzethe (författare)
  • Blennow, KajGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry(Swepub:gu)xbleka (författare)
  • Dankiewicz, JosefLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-jfd (författare)
  • Dragancea, IrinaLund University,Lunds universitet,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-idn (författare)
  • Friberg, HansLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)efor-hfr (författare)
  • Lilja, GiselaLund University,Lunds universitet,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-gal (författare)
  • Insel, Philip S.Lund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,Clinical Memory Research,Lund University Research Groups(Swepub:lu)med-ppi (författare)
  • Rylander, Christian,1960Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care(Swepub:gu)xrylch (författare)
  • Westhall, ErikLund University,Lunds universitet,Klinisk neurofysiologi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Clinical Neurophysiology,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-erw (författare)
  • Kjaergaard, JesperUniversity of Copenhagen (författare)
  • Wise, Matt P.University Hospital of Wales (författare)
  • Hassager, ChristianUniversity of Copenhagen (författare)
  • Kuiper, Michael A.Medical Center Leeuwarden (författare)
  • Stammet, PascalLuxembourg Rescue Services Agency (författare)
  • Wanscher, Michael C.JaegerCopenhagen University Hospital (författare)
  • Wetterslev, JørnCopenhagen University Hospital (författare)
  • Erlinge, DavidLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)kard-der (författare)
  • Horn, JannekeAcademic Medical Center of University of Amsterdam (AMC) (författare)
  • Pellis, TommasoAzienda Ospedaliera G. Panico (författare)
  • Cronberg, TobiasLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Skåne University Hospital(Swepub:lu)efor-tcr (författare)
  • Brain Injury After Cardiac ArrestForskargrupper vid Lunds universitet (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:JAMA Neurology: American Medical Association (AMA)76:1, s. 64-642168-61492168-6157

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