GLASGOW, SCOTLAND — Swiss researchers have identified a hormonal precursor that may make it easier for physicians to identify patients suffering from sepsis, according to a study presented at the 8th European Congress of Endocrinology.
The substance is copeptin, a precursor to vasopressin, which is produced when the body undergoes stress, such as septic shock. Vasopressin is unstable and has a short half-life, making it difficult to use in identifying patients who are suffering from sepsis. Copeptin, on the other hand, is more stable and is derived from the same precursor molecule.
A team of researchers from the departments of endocrinology and internal medicine at University Hospital, Basel, Switzerland, led by Dr. Mirjam Christ-Crain, evaluated 101 consecutive critically ill patients over a 9-month period and compared their relative serum copeptin levels with relative copeptin levels in 50 healthy control subjects. Copeptin levels were measured at admission, day 2, and hospital discharge or death.
Copeptin levels were identified in the blood using a test that will soon be available commercially from the German medical equipment manufacturer Brahms AG.
Of the 101 critically ill patients, 53 had sepsis, severe sepsis, or septic shock; 48 had systemic inflammatory response syndrome (SIRS).
At admission, patients with SIRS had a median copeptin level of 27.6 pmol/L of blood, those with sepsis 50 pmol/L, those with severe sepsis 73.6 pmol/L, and those with septic shock 171.5 pmol/L. In comparison, healthy controls had a median copeptin level of 5 pmol/L, Dr. Christ-Crain said.
Patients with sepsis, severe sepsis, or septic shock who died had median copeptin blood levels of 171.5 pmol/L, compared with 86.8 pmol/L among those who survived.
Septicemia is the 10th-leading cause of death in the United States, claiming 33,464 lives in 2004, according to the Centers for Disease Control and Prevention.
“Copeptin is a novel tool to assess the prognosis of sepsis,” Dr. Christ-Crain observed. “It might help to guide the resource allocation of hospital care to those patients especially in need for intensive surveillance.”
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