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The diagnosis and prognostic value of plasma copeptin in traumatic brain injury: a systematic review and meta-analysis

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Abstract

Objective

The purpose of this meta-analysis was to assess the diagnosis and prognostic value of plasma copeptin levels after traumatic brain injury (TBI).

Methods

The databases PubMed, Cochrane Library, OvidSP, Google Scholar, VIP, CNKI, and WFSD were systematically searched from the inception dates to May 9, 2020. The pooled analysis of relevant data was conducted by the RevMan 5.3 software. Subgroups analysis was performed to explore the impact of age, country, male ratio, follow-up time, and Glasgow coma score (GCS) on the pooled area under curve (AUC) values of assessment mortality.

Results

A total of 17 studies involving 2654 participants were included in the current meta-analysis. The pooled results demonstrated that increased plasma copeptin levels were significantly associated with TBI [SMD, 2.44; 95%CI, 1.59 ~ 3.29; P < 0.00001] and also were significantly associated with mortality [SMD, 1.37; 95%CI, 1.16 ~ 1.58; P < 0.00001], and poor functional outcomes (PFO) [SMD, 1.44; 95%CI, 1.20 ~ 1.68; P < 0.00001] in patients with TBI. Furthermore, the copeptin had a significant value in diagnosing brain concussion [AUC, 0.90; 95%CI, 0.84 ~ 0.95; P < 0.00001] and predicting progressive hemorrhagic injury [AUC, 0.83; 95%CI, 0.80 ~ 0.87; P < 0.00001], acute traumatic coagulopathy [AUC, 0.84; 95%CI, 0.79 ~ 0.89; P < 0.00001], mortality [AUC, 0.89; 95%CI, 0.87 ~ 0.92; P < 0.00001], and PFO [AUC, 0.88; 95%CI, 0.84 ~ 0.92; P < 0.00001] in patients with TBI. The subgroup analysis findings suggested that the age, country, male ratio, follow-up time, and GCS were not obvious factors influencing the pooled AUC values of assessment mortality.

Conclusions

The authors indicate that the plasma copeptin is a potentially promising biomarker for TBI diagnosis and prognosis prediction.

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Abbreviations

TBI:

Traumatic brain injury

OS:

Observational studies

AVP:

Arginine vasopressin

CT-pro-AVP:

Copeptin arginine vasopressin precursor

HPA:

Hypothalamic-pituitary-adrenal axis

NFO:

Neurological functional outcome

GCS:

Glasgow coma score

QUADAS-2:

Quality Assessment of Diagnostic Accuracy Studies version 2

GFO:

Good functional outcomes

PFO:

Poor functional outcomes

SMDs:

Standard mean differences

CIs:

Confidence intervals

I2 :

I-square

AUC:

Area under curve

SE:

Standard error

PHI:

Progressive hemorrhagic injury

ATC:

Acute traumatic coagulopathy

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Acknowledgments

The authors would like to thank the “Neurological Sciences” for providing such an excellent academic platform.

Funding

This study was supported by the Jiangsu Province Key Experiments of Basic and Clinical Translation of Non-coding RNA (201902); Hospital Level Support Projects (Fcjs202050); and Jiangsu Provincial Key Medical Talents Program (QNRC2016326).

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Author notes

  1. Jun Zhang, Haili Wang and Yuping Li contributed equally to this work.

Authors and Affiliations

  1. Department of Clinical Medicine, Dalian Medical University, Dalian, Liaoning, China

    Jun Zhang & Haili Wang

  2. Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China

    Yuping Li, Hengzhu Zhang, Xiaoguang Liu & Lun Dong

  3. Department of Clinical Medicine, Tongji University School of Medicine, Shanghai, China

    Lei Zhu

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  1. Jun Zhang
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Correspondence to Lun Dong.

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Zhang, J., Wang, H., Li, Y. et al. The diagnosis and prognostic value of plasma copeptin in traumatic brain injury: a systematic review and meta-analysis. Neurol Sci 42, 539–551 (2021). https://doi.org/10.1007/s10072-020-05019-8

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