Serum neurofilament measurement improves clinical risk scores for outcome prediction after cardiac arrest: results of a prospective study

Table 2 Comparison between scores to predict primary and secondary endpoints

	Good neurological outcome (CPC 1–2)	Poor neurological outcome (CPC 3–5)	p value	Univariate		Multivariate^a adjusted	NFL and OHCA score: multivariate^a adjusted		NFL and CAHP score: multivariate^a adjusted
	n = 66	n = 98	p value	OR (95% CI), p	AUC	OR (95% CI), p	OR (95% CI), p	AUC combined with NFL	OR (95% CI), p	AUC combined with NFL
Primary endpoint: neurological outcome (CPC)
NfL, mean (SD)	49 (111)	685 (1787)	0.004	2.93 (2.01, 4.27), p < 0.001	0.82	3.44 (2.13, 5.55), p < 0.001	2.81 (1.69, 4.67), p < 0.001	0.89	3.45 (1.89, 6.29), p < 0.001	0.92
NfL, median (IQR)	27 (13, 46)	116 (41, 330)	< 0.001	2.93 (2.01, 4.27), p < 0.001	0.82	3.44 (2.13, 5.55), p < 0.001	2.81 (1.69, 4.67), p < 0.001		3.45 (1.89, 6.29), p < 0.001
Quartiles of NFL
1st quartile	29 (44%)	12 (12%)	< 0.001	Reference group		Reference group	Reference group		Reference group
2nd quartile	25 (38%)	16 (16%)		1.55 (0.62, 3.88), p = 0.35		1.35 (0.46, 4.03), p = 0.59	1.02 (0.28, 3.7), p = 0.97		1.01 (0.24, 4.23), p = 0.98
3rd quartile	10 (15%)	31 (32%)		7.49 (2.81, 19.96), p < 0.001		5.59 (1.65, 18.94), p = 0.006	3.33 (0.82, 13.41), p = 0.091		3.99 (0.84, 18.96), p = 0.08
4th quartile	2 (3%)	39 (40%)		47.12 (9.78, 227.01), p < 0.001		127.26 (16.53, 979.47), p < 0.001	92.39 (8.47, 1007.63), p < 0.001		140.48 (10.5, 1880.26), p < 0.001
OHCA, mean (SD)	11 (16)	32 (17)	< 0.001	1.08 (1.05, 1.1), p < 0.001	0.82	1.08 (1.05, 1.11), p < 0.001	1.07 (1.04, 1.11), p < 0.001
CAHP, mean (SD)	118 (41)	182 (38)	< 0.001	1.04 (1.03, 1.05), p < 0.001	0.89	1.04 (1.03, 1.05), p < 0.001			1.04 (1.02, 1.06),p < 0.001

	Good neurological outcome (mRs 0–2)	Poor neurological outcome (mRs 3–6)	p value	Univariate		Multivariate^a adjusted	NFL and OHCA score: multivariate^a adjusted		NFL and CAHP score: multivariate^a adjusted
	n = 53	n = 111	p value	OR (95% CI), p	AUC	OR (95% CI), p	OR (95% CI), p	AUC combined with NFL	OR (95% CI), p	AUC combined with NFL
Secondary endpoint: Neurological outcome (mRs)
NFL, mean (SD)	51 (123)	609 (1691)	0.018	2.72 (1.85, 3.98), p < 0.001	0.8	3.01 (1.88, 4.83), p < 0.001	2.47 (1.52, 4.04), p < 0.001	0.87	2.78 (1.64, 4.72), p < 0.001	0.88
NfL, median (IQR)	21 (12, 40)	92 (37, 284)	< 0.001	2.72 (1.85, 3.98), p < 0.001	0.8	3.01 (1.88, 4.83), p < 0.001	2.47 (1.52, 4.04), p < 0.001		2.78 (1.64, 4.72), p < 0.001
Quartiles of NFL
1st quartile	26 (49.1%)	15 (13.5%)	< 0.001	Reference group		Reference group	Reference group		Reference group
2nd quartile	18 (34.0%)	23 (20.7%)		2.21 (0.91, 5.37), p = 0.078		2.11 (0.73, 6.1), p = 0.17	1.8 (0.56, 5.83), p = 0.326		1.89 (0.55, 6.46), p = 0.309
3rd quartile	7 (13.2%)	34 (30.6%)		8.42 (3, 23.64), p < 0.001		6.14 (1.73, 21.8), p = 0.005	3.6 (0.9, 14.41), p = 0.07		3.97 (0.94, 16.7), p = 0.06
4th quartile	2 (3.8%)	39 (35.1%)		33.8 (7.13, 160.31), p < 0.001		66.08 (9.66, 452.17), p < 0.001	42.17 (4.72, 376.98), p = 0.001		53.32 (5.52, 514.78), p = 0.001
OHCA, mean (SD)	11 (16)	30 (18)	< 0.001	1.06 (1.04, 1.09), p < 0.001	0.79	1.07 (1.04, 1.1), p < 0.001	1.06 (1.03, 1.08), p < 0.001
CAHP, mean (SD)	117 (42)	175 (42)	< 0.001	1.03 (1.02, 1.04), p < 0.001	0.84	1.03 (1.02, 1.04), p < 0.001			1.03 (1.02, 1.04), p < 0.001

	Survivors	Non-Survivors	p value	Univariate		Age, gender, comorbidities adjusted	NFL and OHCA score: multivariate^a adjusted		NFL and CAHP score: multivariate^a adjusted
	n = 73	n = 91	p value	OR (95% CI), p	AUC	OR (95% CI), p	OR (95% CI), p	AUC combined with NFL	OR (95% CI), p	AUC combined with NFL
Secondary endpoint: 30-day mortality
NfL, mean (SD)	136 (701)	664 (1763)	0.017	2.77 (1.94, 3.95), p < 0.001	0.83	2.97 (1.91, 4.62), p < 0.001	2.42 (1.54, 3.8), p < 0.001	0.87	2.59 (1.6, 4.2), p < 0.001	0.89
NfL, median (IQR)	27 (13, 47)	128 (45, 330)	< 0.001	2.77 (1.94, 3.95), p < 0.001	0.83	2.97 (1.91, 4.62), p < 0.001	2.42 (1.54, 3.8), p < 0.001		2.59 (1.6, 4.2), p < 0.001
Quartiles of NFL
1st quartile	33 (45%)	8 (9%)	< 0.001	Reference group		Reference group	Reference group		Reference group
2nd quartile	25 (34%)	16 (18%)		2.64 (0.98, 7.14), p = 0.056		2.47 (0.75, 8.1), p = 0.135	2.29 (0.62, 8.42), p = 0.211		2.32 (0.58, 9.3), p = 0.235
3rd quartile	11 (15%)	30 (33%)		11.25 (3.99, 31.71), p < 0.001		7.85 (2.19, 28.09), p = 0.002	5.49 (1.39, 21.76), p = 0.015		5.87 (1.35, 25.57), p = 0.019
4th quartile	4 (5%)	37 (41%)		38.16 (10.52, 138.44), p < 0.001		92.29 (15.16, 561.71), p < 0.001	49.33 (7.29, 333.79), p < 0.001		65.12 (8.32, 509.95), p < 0.001
OHCA, mean (SD)	14 (18)	32 (17)	< 0.001	1.06 (1.04, 1.09), p < 0.001	0.77	1.07 (1.04, 1.1), p < 0.001	1.05 (1.03, 1.08), p < 0.001
CAHP, mean (SD)	123 (43)	182 (38)	< 0.001	1.03 (1.02, 1.04), p < 0.001	0.85	1.03 (1.02, 1.04), p < 0.001			1.03 (1.02, 1.04), p < 0.001

Data presented as mean (SD) and median (Inter Quartile Range, IQR).; NfL = Neurofilament Light Chain (pg/ml); AUC = area under the curve; CAHP = Cardiac Arrest Hospital prognosis (-score); CPC = cerebral performance category; OHCA = Out-of-Hospital Cardiac Arrest (-score); OR = odds ratio; ROC = receiver operating characteristics curve
^aAdjusted for age, gender, comorbidities

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