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  • Copeptin as a marker for severity and prognosis of aneurysmal subarachnoid hemorrhage

    Final Number:

    Christian Fung MD; Gian Marco De Marchis; Mira Katan; Marleen Seiler; Marcel Arnold; Jan Gralla; Andreas Raabe MD; Jürgen Beck

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: 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 SAH had plasma copeptin levels measured with a validated chemiluminescence sandwich immunoassay. The primary endpoint was the association of admission copeptin levels 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 had a significant association with the severity of SAH 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 SAH.

    Patient Care: Copeptin might evolve as a useful serum marker for SAH. Thereby it might help in selecting high risk patients and might also be useful in the diagnosis of SAH related vasospasm.

    Learning Objectives: By the end of this session the audience should know 1)about the possible usefulness of Copeptin as serum marker in SAH 2)that Copeptin is associated with the severity of SAH, the amount of subarachnoid blood and the occurence of ICH

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