title: Plasma copeptin level predicts acute traumatic coagulopathy and progressive hemorrhagic injury after traumatic brain injury.
abstract: Higher plasma copeptin levels correlate with poor clinical outcomes after traumatic brain injury. Nevertheless, their links with acute traumatic coagulopathy and progressive hemorrhagic injury are unknown. Therefore, we aimed to investigate the relationship between plasma copeptin levels, acute traumatic coagulopathy and progressive hemorrhagic injury in patients with severe traumatic brain injury. We prospectively studied 100 consecutive patients presenting within 6h from head trauma. Progressive hemorrhagic injury was present when the follow-up computerized tomography scan reported any increase in size or number of the hemorrhagic lesion, including newly developed ones. Acute traumatic coagulopathy was defined as an activated partial thromboplastic time greater than 40s and/or international normalized ratio greater than 1.2 and/or a platelet count less than 120×10(9)/L. We measured plasma copeptin levels on admission using an enzyme-linked immunosorbent assay in a blinded fashion. In multivariate logistic regression analysis, plasma copeptin level emerged as an independent predictor of progressive hemorrhagic injury and acute traumatic coagulopathy. Using receiver operating characteristic curves, we calculated areas under the curve for progressive hemorrhagic injury and acute traumatic coagulopathy. The predictive performance of copeptin was similar to that of Glasgow Coma Scale score. However, copeptin did not obviously improve the predictive value of Glasgow Coma Scale score. Thus, copeptin may help in the prediction of progressive hemorrhagic injury and acute traumatic coagulopathy after traumatic brain injury.
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Ding-Bo
authors.initials: DB
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Wen-Hua
authors.initials: WH
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China. Electronic address: dxqhyy@163.com.
authors.forename: Xiao-Qiao
authors.initials: XQ
authors.lastname: Dong
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Du
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Yong-Feng
authors.initials: YF
authors.lastname: Shen
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Zu-Yong
authors.initials: ZY
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Zhi-Hao
authors.initials: ZH
authors.lastname: Che
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Qun-Jie
authors.initials: QJ
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
authors.forename: Yuan-Feng
authors.initials: YF
authors.lastname: Du
mesh_terms: D000208:Acute Disease; D000328:Adult; D020201:Brain Hemorrhage, Traumatic / Q000097:blood* / Q000150:complications; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000209:etiology; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices
chemical_list: D006020:Glycopeptides; C048197:copeptins
keywords: Acute traumatic coagulopathy; Biomarker; Copeptin; Progressive hemorrhagic injury; Traumatic brain injury