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• W3194870832 abstract "The majority of unconscious patients after cardiac arrest (CA) do not fulfill guideline criteria for a likely poor outcome, their prognosis is considered indeterminate. We compared brain injury markers in blood for prediction of good outcome and for identifying false positive predictions of poor outcome as recommended by guidelines.Retrospective analysis of prospectively collected serum samples at 24, 48 and 72 h post arrest within the Target Temperature Management after out-of-hospital cardiac arrest (TTM)-trial. Clinically available markers neuron-specific enolase (NSE) and S100B, and novel markers neurofilament light chain (NFL), total tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) were analysed. Normal levels with a priori cutoffs specified by reference laboratories or defined from literature were used to predict good outcome (no to moderate disability, Cerebral Performance Category scale 1-2) at 6 months.Seven hundred and seventeen patients were included. Normal NFL, tau and GFAP had the highest sensitivities (97.2-98% of poor outcome patients had abnormal serum levels) and NPV (normal levels predicted good outcome in 87-95% of patients). Normal S100B and NSE predicted good outcome with NPV 76-82.2%. Normal NSE correctly identified 67/190 (35.3%) patients with good outcome among those classified as indeterminate outcome by guidelines. Five patients with single pathological prognostic findings despite normal biomarkers had good outcome.Low levels of brain injury markers in blood are associated with good neurological outcome after CA. Incorporating biomarkers into neuroprognostication may help prevent premature withdrawal of life-sustaining therapy." @default.
• W3194870832 created "2021-08-30" @default.
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• W3194870832 date "2021-08-21" @default.
• W3194870832 modified "2023-10-16" @default.
• W3194870832 title "Serum markers of brain injury can predict good neurological outcome after out-of-hospital cardiac arrest" @default.
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• W3194870832 doi "https://doi.org/10.1007/s00134-021-06481-4" @default.
• W3194870832 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/8421280" @default.
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