Frontiers in Neurology (Apr 2022)

Association Between Copeptin and Six-Month Neurologic Outcomes in Patients With Moderate Traumatic Brain Injury

  • Jin Pyeong Jeon,
  • Seonghyeon Kim,
  • Tae Yeon Kim,
  • Sung Woo Han,
  • Seung Hyuk Lim,
  • Dong Hyuk Youn,
  • Bong Jun Kim,
  • Eun Pyo Hong,
  • Chan Hum Park,
  • Jong-Tae Kim,
  • Jun Hyong Ahn,
  • Jong Kook Rhim,
  • Jeong Jin Park,
  • Heung Cheol Kim,
  • Suk Hyung Kang

DOI
https://doi.org/10.3389/fneur.2021.749110
Journal volume & issue
Vol. 12

Abstract

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BackgroundCopeptin has been reported as a predictive biomarker for the prognosis after traumatic brain injury (TBI). However, most of them were in patients with severe TBI and limited value in predicting outcomes in patients with moderate TBI defined as Glasgow Coma Scale (GCS) score from 9 to 12. We aimed to investigate the predictive value of copeptin in assessing the neurologic outcome following moderate TBI.MethodsPatients were prospectively enrolled between May 2017 and November 2020. We consecutively measured plasma copeptin within 24 h after trauma, days 3, 5, and 7 using ELISA. The primary outcome was to correlate plasma copeptin levels with poor neurologic outcome at 6 months after moderate TBI. The secondary outcome was to compare the prognostic accuracy of copeptin and C-reactive protein (CRP) in assessing the outcome of patient.ResultsA total of 70 patients were included for the final analysis. The results showed that 29 patients (41.4%) experienced a poor neurologic outcome at 6 months. Multivariable logistic regression analysis revealed that increased copeptin (odds ration [OR] = 1.020, 95% CI: 1.005–1.036), GCS score of 9 or 10 (OR = 4.507, 95% CI: 1.266–16.047), and significant abnormal findings on CT (OR = 4.770; 95% CI: 1.133–20.076) were independent risk factors for poor outcomes. Consecutive plasma copeptin levels were significantly different according to outcomes (p < 0.001). Copeptin on day 7 exhibited better prognostic performance than CRP with an area under receiver operating characteristic curve (AUROC) difference of 0.179 (95% CI: 0.032–0.325) in predicting 6-month poor outcomes.ConclusionPlasma copeptin level can be a useful marker in predicting 6-month outcomes in patients with moderate TBI.

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