Journal of Cerebrovascular Disease 2019 Vol.2 No.1 1-32
Serum Copeptin and In-Hospital Major Adverse Events after Head Trauma: A Multicenter Study
Author(s): Yu-Hao Shen1,Quan Du1,Wen-Hua Yu1,Xiao-Qiao Dong1,Ding-Bo Yang1,Jian-Wei Pan2,Jian-Feng Weng3,Li-Feng Luo4,Meng Cen4,Zu-Yong Zhang5,Yong-Ke Zheng6,Wei Hu6,Li-Xin Zhang7,Mao-Fa Xu7
1Department of Neurosurgery, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, 261 Huansha Road, Hangzhou 310006, China
2Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University, School of Medicine
3Department of Neurosurgery, The CHC International Hospital, 599 Shiji Avenue, Ningbo 315315, China
4Department of Neurosurgery, The CHC International Hospital, 599 Shiji Avenue, Cixi 315315, China
5Department of Neurosurgery, The Hangzhou Hospital of Traditional Chinese Medicine, 453 Tiyuchang Road, Hangzhou 310007, China
6Department of Intensive Care Unit, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, 261 Huansha Road, Hangzhou 310006, China
7Department of Neurosurgery, The Second People’s Hospital of Yuhang District, 80 Anle Road, Hangzhou 311121, China
Corresponding Author: Xiao-Qiao Dong
Corresponding email(s): firstname.lastname@example.org
Key Words: Traumatic brain injury; Copeptin; Acute lung injury; Acute traumatic coagulopathy; Acute progressive hemorrhagic injury; Post-traumatic cerebral infarction
Background: Copeptin is a biomarker for brain injury. However, it is unclear whether it is discriminative regarding in-hospital major adverse events (IMAEs), including acute lung injury, acute traumatic coagulopathy, progressive hemorrhagic injury and post-traumatic cerebral infarction, in patients with traumatic brain injury (TBI). This study was aimed at investigating the relationship between the serum copeptin level and occurrences of IMAEs.
Methods: In this multicenter observational study, we recruited 173 severe TBI patients and 173 healthy controls. Serum levels of copeptin, interleukin-6, tumor necrosis factor-alpha, C-reactive protein, myelin basic protein, glial fibrillary astrocyte protein, S100B, neuron-specific enolase, phosphorylated axonal neurofilament subunit H, tau protein and ubiquitin carboxyl-terminal hydrolase L1 were quantified using available enzyme-linked immunosorbent assays. Areas under the receiver operating characteristic curves (AUCs) were estimated to determine and compare their discriminatory ability for IMAEs.
Results: Patients had dramatically elevated levels of the afore-mentioned biomarkers, as compared with controls. In the discrimination of IMAEs, serum copeptin had a significantly higher AUC than serum interleukin-6, tumor necrosis factor-alpha and C-reactive protein and its AUC was similar to that of the Glasgow coma scale (GCS) score and the other remaining biomarkers mentioned above. Except copeptin, no other biomarkers could significantly improve the AUC of the GCS score.
Conclusion: Serum copeptin levels combined with the GCS score might aid in discriminating IMAEs following TBI.