Background: Early prognostication in trauma patients is challenging, but particularly important. We wanted to\nexplore the ability of copeptin, the C-terminal fragment of arginine vasopressin, to identify major trauma, defined as\nInjury Severity Score (ISS) > 15, in a heterogeneous cohort of trauma patients and to compare its performances with\nlactate. We also evaluated copeptin performance in predicting other clinical outcomes: mortality, hospital\nadmission, blood transfusion, emergency surgery, and Intensive Care Unit (ICU) admission.\nMethods: This single center, pragmatic, prospective observational study was conducted at Arcispedale Santa Maria\nNuova, a level II trauma center in Reggio Emilia, Italy. Copeptin determination was obtained on Emergency\nDepartment (ED) arrival, together with venous lactate. Different outcomes were measured including ISS, Revised\nTrauma Score (RTS), hospital and ICU admission, blood transfusion, emergency surgery, and mortality.\nResults: One hundred and twenty five adult trauma patients admitted to the ED between June 2017 and March\n2018. Copeptin showed a good ability to identify patients with ISS > 15 (AUC 0.819). Similar good performances\nwere recorded also in predicting other outcomes. Copeptin was significantly superior to lactate in identifying\npatients with ISS > 15 (P 0.0015), and in predicting hospital admission (P 0.0002) and blood transfusion (P 0.016).\nComparable results were observed in a subgroup of patients with RTS 7.84.\nConclusions: In a heterogeneous group of trauma patients, a single copeptin determination at the time of ED\nadmission proved to be an accurate biomarker, statistically superior to lactate for the identification of major trauma,\nhospital admission, and blood transfusion, while no statistical difference was observed for ICU admission and\nemergency surgery. These results, if confirmed, may support a role for copeptin during early management of\ntrauma patients.
Loading....