Research Reports - Plasma copeptin concentration and outcome after pediatric traumatic brain injury

Peptides. 2013 Feb 8;42C:43-47

Lin C, Wang N, Shen ZP, Zhao ZY

Higher plasma copeptin level has been associated with poor outcomes of critical
illness. The present study was undertaken to investigate the plasma copeptin
concentrations in children with traumatic brain injury (TBI) and to analyze the
correlation of copeptin with disease outcome. Plasma copeptin concentrations of
126 healthy children and 126 children with acute severe TBI were measured by
enzyme-linked immunosorbent assay. Twenty-one patients (16.7%) died and 38
patients (30.2%) had an unfavorable outcome (Glasgow Outcome Scale score of 1-3)
at 6 months. Plasma copeptin level was obviously higher in patients than in
healthy children (46.2±20.8pmol/L vs. 9.6±3.0pmol/L, P<0.001). Plasma copeptin
level was identified as an independent predictor for 6-month mortality [odds
ratio (OR) 1.261, 95% confidence interval (CI) 1.112-1.538, P=0.005] and
unfavorable outcome (OR 1.313, 95% CI 1.146-1.659, P=0.003). The predictive value
of copeptin was similar to that of Glasgow Coma Scale (GCS) score for 6-month
mortality [area under curve (AUC) 0.832, 95% CI 0.755-0.892 vs. AUC 0.873, 95% CI
0.802-0.926, P=0.412] and unfavorable outcome (AUC 0.863, 95% CI 0.790-0.918 vs.
AUC 0.885, 95% CI 0.816-0.935, P=0.596). Copeptin improved the AUC of GCS score
for 6-month unfavorable outcome (AUC 0.929, 95% CI 0.869-0.967, P=0.013), but not
for 6-month mortality (AUC 0.887, 95% CI 0.818-0.936, P=0.600). Thus, plasma
copeptin level represents a novel biomarker for predicting 6-month clinical
outcome in children with TBI.

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