The 90-day prognostic value of copeptin in acute intracerebral hemorrhage.

Abstract

The aim of the study was to assess the 90-day prognostic value of copeptin in a group of Chinese patients with acute intracerebral hemorrhage (ICH). In this study, all consecutive patients with first-ever ICH from 2010 to 2012 were recruited to participate in the study. On admission, plasma copeptin levels were measured by enzyme-linked immunosorbent assay. The Glasgow Coma Scale (GCS) and Hemphill ICH scores were assessed on admission blinded to plasma copeptin levels. For the assessment of functional outcome at 90 days, Modified Rankin Scale was used. During the study period, 271 patients were diagnosed as ICH and were included in the analysis. The median GCS score on admission was 11 points. Patients with an unfavorable outcomes and non-survivors had significantly increased plasma copeptin levels on admission (P < 0.001 for both). Copeptin was an independent prognostic marker of functional outcome and death [odds ratio 3.45 (95 % confidence intervals: 1.85-6.99) and 3.66 (2.42-8.28), respectively, P < 0.001 for both, adjusted for age, the hematoma volume and other predictors] in patients with ICH. In receiver operating characteristic curve analysis, copeptin could improve the Hemphill score in predicting 90-day functional outcome [area under the curve (AUC) of the combined model, 0.83; 95 % CI 0.74-0.90; P < 0.001] and mortality (AUC of the combined model, 0.88; 95 % CI 0.82-0.93; P < 0.001). In conclusion, our study suggests that copeptin levels are a useful tool to predict unfavorable functional outcome and mortality 90 days after ICH and have a potential to assist clinicians.