title: Copeptin as a marker for severity and prognosis of aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Grading of patients with aneurysmal subarachnoid hemorrhage (aSAH) is often confounded by seizure, hydrocephalus or sedation and the prediction of prognosis remains difficult. Recently, copeptin has been identified as a serum marker for outcomes in acute ischemic stroke and intracerebral hemorrhage (ICH). We investigated whether copeptin might serve as a marker for severity and prognosis in aSAH.
  
  
  METHODS
  Eighteen consecutive patients with aSAH had plasma copeptin levels measured with a validated chemiluminescence sandwich immunoassay. The primary endpoint was the association of copeptin levels at admission with the World Federation of Neurological Surgeons (WFNS) grade score after resuscitation. Levels of copeptin were compared across clinical and radiological scores as well as between patients with ICH, intraventricular hemorrhage, hydrocephalus, vasospasm and ischemia.
  
  
  RESULTS
  Copeptin levels were significantly associated with the severity of aSAH measured by WFNS grade (P = 0.006), the amount of subarachnoid blood (P = 0.03) and the occurrence of ICH (P = 0.02). There was also a trend between copeptin levels and functional clinical outcome at 6-months (P = 0.054). No other clinical outcomes showed any statistically significant association.
  
  
  CONCLUSIONS
  Copeptin may indicate clinical severity of the initial bleeding and may therefore help in guiding treatment decisions in the setting of aSAH. These initial results show that copeptin might also have prognostic value for clinical outcome in aSAH.
authors: Department of Neurosurgery, Bern University Hospital, Bern, Switzerland.
authors: Christian
authors: C
authors: Fung
authors: Gian Marco
authors: GM
authors: De Marchis
authors: Mira
authors: M
authors: Katan
authors: Marleen
authors: M
authors: Seiler
authors: Marcel
authors: M
authors: Arnold
authors: Jan
authors: J
authors: Gralla
authors: Andreas
authors: A
authors: Raabe
authors: Jürgen
authors: J
authors: Beck
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins