Table 1

Overview of studies investigating the use of copeptin in different clinical settings.

Clinical scenario

Setting

Number of patients

Outcome


AECOPD [34]

ED

167

Copeptin levels > 40 pmol/L associated with prolonged hospital stay and long-term clinical failure (death or rehospitalization for AECOPD up to six months after inclusion).


LRTI [35]

ED

545

Copeptin levels increased with increasing severity of LRTI, as classified by the Pneumonia Severity Index

- predictive of mortality (AUC 0.75)

- copeptin levels in survivors 24.3 pmol/L (normal: 10.8 to 43.8 pmol/L), versus 70.0 pmol/L (normal: 28.8 to 149 pmol/L) in non-survivors

- optimal threshold of copeptin, 53 pmol/L; sensitivity to correctly predict mortality, 58% with a specificity of 80%; LR+ 3.0, LR- 0.5


Hemorrhagic and septic shock [15]

ICU

101

Copeptin levels increased with disease severity from systemic inflammatory response syndrome to sepsis and severe sepsis to septic shock

- copeptin levels in non-survivors, 171.5 pmol/L versus survivors, 86.8 pmol/L, P < 0.001

- predictive of mortality (AUC 0.75)

- optimal prognostic accuracy of copeptin at 96 pmol/L; sensitivity, 61.5%, specificity 83.8%


Acute ischemic stroke [49]

ED

362

Copeptin

- associated with severity of stroke and lesion size

- predicts functional outcome (AUC 0.73) and mortality (AUC 0.82) after three months


Cerebrovascular re-event after transient ischemic attack within 90 days [36]

ED

107

- AUC for copeptin to predict re-event within 90 days, 0.73.

- at cutoff of 9.0 pmol/L for copeptin; sensitivity, 80%, specificity, 76%


One-year outcome in patients with acute stroke [37]

One-year follow-up on ED patients

341 of 362

Copeptin predicts

- one-year mortality after stroke (AUC 0.74)

- functional outcome (AUC 0.72)


Acute spontaneous intracerebral hemorrhage [50]

ED

40

Copeptin predicts

- 30-day mortality (AUC 0.88), comparable with that of GCS (AUC 0.82)

- 90-day functional outcome (AUC 0.68)


Traumatic brain injury [38]

Neurosurgery

94

Copeptin

- predicts one-month mortality (AUC 0.874), similar to that of GCS

- copeptin levels > 451.8 pg/mL; sensitivity, 88.5%, specificity, 75%, in prediction of one-month mortality


AECOPD: acute exacerbation of chronic obstructive pulmonary disease; AUC: area under the curve; ED: emergency department; GCS: Glasgow Coma Scale; ICU: intensive care unit; LR-: negative likelihood ratio; LR+: positive likelihood ratio.

Nickel et al. BMC Medicine 2012 10:7   doi:10.1186/1741-7015-10-7

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