Neurofilament light as a predictor of long- and short-term outcomes in critically ill children

Abstract

Abstract Purpose Plasma neurofilament light (NFL) is a marker of neuronal injury, associated with poor neurological outcomes in adults and neonates in a wide range of diseases. We sought to describe the associations between NFL at admission (NFLadm) and outcomes in a heterogenous cohort of critically ill children needing unplanned admission to the pediatric intensive care unit (PICU). Materials and methods We analysed prospectively collected biobank samples from critically-ill children with unplanned admissions to PICU. Samples were selected for survivors who had a 12-month follow-up with parent-completed Pediatric Quality of Life Inventory (PedsQL) scores as the primary outcome of interest. Results Data from 52 children were analysed. The median NFL was 17.0 pg/ml (IQR 5.8–28.1). There were no significant associations between NFLadm levels and PedsQL (NFLadm-adjusted odds ratio 0.99, 95% CI 0.97, 1.02) at 12 months. NFL showed associations with outcomes at PICU discharge, such as change in functional status and need for organ support but interpretation is limited by sample size. Conclusions Admission NFL values were not associated with 12-month quality of life outcomes in a heterogenous cohort of children admitted to PICU.