The potential of serum copeptin as a prognostic marker of mortality in patients with sepsis, severe sepsis, or septic shock

Abstract

Background The present study sought to investigate the correlation of copeptin with the severity of septic status and to analyze the usefulness of copeptin as a predictor of mortality in patients with sepsis, severe sepsis, and septic shock. Patients and methods This prospective observational study was conducted in Alexandria Main University Hospital. The participants were 60 patients who had sepsis, severe sepsis, and septic shock consecutively admitted to the internal medicine ward and the ICU from October 2014 to August 2015. All patients were subjected to full history taking, clinical examination, as well as routine laboratory workup including serum Na+, serum K+, and serum lactate and imaging parameters. Serum copeptin was measured on the first or second day of admission. APACHE II scores were assigned on the basis of the most pessimistic clinical and laboratory data obtained during the first 24 h following admission. Patients were followed up for 10 days after admission, and the 10-day mortality rate was calculated. In addition, 20 age-matched and sex-matched healthy participants were enrolled as controls. Results Measured serum copeptin was significantly increased in groups I, II, and III in comparison with the control group (P<0.001). The value was increasing from sepsis to severe sepsis to septic shock. When patients were followed up for early mortality within 7–10 days, we found that the measured serum copeptin was higher in nonsurvivors than in survivors but without statistically significant difference. It was concluded according to the study of receiver operating characteristic curves that APACHE II score is more sensitive and specific than the serum copeptin when used as a prognostic tool to predict mortality in patients with severe sepsis and septic shock. Conclusion Our data demonstrate that serum copeptin levels increase progressively with the severity of sepsis and may be considered an independent predictor of mortality in severe sepsis and septic shock with superiority of APACHE II scoring.