• Olgun Demir, Adem Az, Sumeyye Cakmak, and Ozgur Sogut.
• Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Ugur Mumcu, Atatürk Street 54, 34265, Sultangazi, Istanbul, Turkey.
• Ir J Med Sci. 2024 Oct 11.

BackgroundThe efficacy of copeptin in patients with severe head injuries remains unclear.AimsTo investigate the role of serum copeptin levels in detecting intracranial injury, assessing trauma severity, and predicting outcomes in adults with graded traumatic brain injury (TBI).MethodsThis prospective non-randomized controlled study enrolled 78 adults with isolated head trauma, as well as 59 age- and sex-matched controls. Baseline serum copeptin levels were measured in both groups. Patients were categorized by head trauma severity using Glasgow Coma Scale (GCS) scores (severe GCS 3-8, moderate GCS 9-13, mild GCS 14-15) and by the presence of intracerebral or extracerebral lesions on cranial computed tomography (CCT). Patients were also classified as survivors or non-survivors. Serum copeptin levels were compared among these.ResultsMean serum copeptin levels were significantly higher in patients with graded TBI than in controls. Furthermore, patients with severe and moderate head trauma had significantly higher copeptin levels compared with patients exhibiting mild trauma. An optimal copeptin cutoff value of > 1147 pg/mL was identified, indicating the presence of moderate or severe trauma in TBI patients. Patients with abnormal CCT findings had significantly higher mean serum copeptin levels compared with patients exhibiting normal CCT scans. Non-survivors also showed significantly higher serum copeptin levels compared with survivors.ConclusionSerum copeptin levels rise after graded TBI and can distinguish between patients with and without intracranial or extracranial lesions evident on CCT. Copeptin levels also aid in identifying moderate or severe TBI and in predicting 28-day mortality.© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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