U Y Cavus1,2, S Yildirim3, B Gurer4, K Dibek3, D Yilmaz5, G Ozturk6, F Buyukcam3, E Sonmez7. 1. Department of Emergency Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. acildrumut@yahoo.com. 2. , İrfan Bastug cad. S.B. Diskapi Yildirim Beyazit Egitim ve Arastirma Hastanesi, Acil Tip Klinigi, 06110, Ankara, Turkey. acildrumut@yahoo.com. 3. Department of Emergency Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. 4. Department of Neurosurgery, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. 5. Karabük State Hospital, Karabük, Turkey. 6. Department of Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. 7. Department of Emergency Medicine, Faculty of Medicine, Bezmialem Vakıf Gureba University, Istanbul, Turkey.
Abstract
PURPOSE: Traumatic brain injury (TBI) is one of the most common causes of death among trauma patients. Earlier prediction of possible poor neurological outcomes, even upon admission to the emergency department, may help to guide treatment. The aim of this prospective study was to assess the predictive value of plasma copeptin levels for early morbidity and mortality in patients with isolated TBI. METHODS: This prospective study comprised 53 patients who were admitted to the emergency department with isolated TBI. Forty-two of these patients (group I) survived at least 1 month after the TBI; the other 11 (group II) did not. Plasma levels of copeptin were measured in these TBI patients at admission and 6 h after trauma, and were compared with those of healthy volunteers (group III). RESULTS: At admission, the copeptin levels of the TBI patients (groups I and II combined) were not statistically significantly different from those of the control group (III). The copeptin levels 6 h after trauma were also not statistically significantly different from those at admission. Δ-Copeptin levels (the difference between the copeptin level at the 6th hour after trauma and that at admission) were higher in the patients who died within a month of the TBI. Further, Δ-copeptin levels were higher in patients who showed no improvement in the modified Rankin score when compared with patients with an improved modified Rankin score. The best cutoff point for Δ-copeptin was 0.51 ng/ml for predicting mortality and 0.23 ng/ml for predicting improvement in the modified Rankin score. CONCLUSIONS: Plasma Δ-copeptin levels may help physicians predict the prognoses of patients suffering from traumatic brain injury.
PURPOSE:Traumatic brain injury (TBI) is one of the most common causes of death among traumapatients. Earlier prediction of possible poor neurological outcomes, even upon admission to the emergency department, may help to guide treatment. The aim of this prospective study was to assess the predictive value of plasma copeptin levels for early morbidity and mortality in patients with isolated TBI. METHODS: This prospective study comprised 53 patients who were admitted to the emergency department with isolated TBI. Forty-two of these patients (group I) survived at least 1 month after the TBI; the other 11 (group II) did not. Plasma levels of copeptin were measured in these TBI patients at admission and 6 h after trauma, and were compared with those of healthy volunteers (group III). RESULTS: At admission, the copeptin levels of the TBI patients (groups I and II combined) were not statistically significantly different from those of the control group (III). The copeptin levels 6 h after trauma were also not statistically significantly different from those at admission. Δ-Copeptin levels (the difference between the copeptin level at the 6th hour after trauma and that at admission) were higher in the patients who died within a month of the TBI. Further, Δ-copeptin levels were higher in patients who showed no improvement in the modified Rankin score when compared with patients with an improved modified Rankin score. The best cutoff point for Δ-copeptin was 0.51 ng/ml for predicting mortality and 0.23 ng/ml for predicting improvement in the modified Rankin score. CONCLUSIONS: Plasma Δ-copeptin levels may help physicians predict the prognoses of patients suffering from traumatic brain injury.
Authors: Susan L Bratton; Randall M Chestnut; Jamshid Ghajar; Flora F McConnell Hammond; Odette A Harris; Roger Hartl; Geoffrey T Manley; Andrew Nemecek; David W Newell; Guy Rosenthal; Joost Schouten; Lori Shutter; Shelly D Timmons; Jamie S Ullman; Walter Videtta; Jack E Wilberger; David W Wright Journal: J Neurotrauma Date: 2007 Impact factor: 5.269
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