{
    "abstract": "Rapid risk stratification is a core task in emergency medicine. Identifying patients at high and low risk shortly after admission could help clinical decision-making regarding treatment, level of observation, allocation of resources and post discharge follow-up. The purpose of the present study was to determine short-, mid- and long-term mortality by plasma measurement of copeptin in unselected admitted patients.\nConsecutive patients >40-years-old admitted to an inner-city hospital were included. Within the first 24 hours after admission, a structured medical interview was conducted and self-reported medical history was recorded. All patients underwent a clinical examination, an echocardiographic evaluation and collection of blood for later measurement of risk markers.\nPlasma for copeptin measurement was available from 1,320 patients (average age 70.5 years, 59.4% women). Median follow-up time was 11.5 years (range 11.0 to 12.0 years). Copeptin was elevated (that is, above the 97.5 percentile in healthy individuals).Mortality within the first week was 2.7% (17/627) for patients with elevated copeptin (above the 97.5 percentile, that is, >11.3 pmol/L) compared to 0.1% (1/693) for patients with normal copeptin concentrations (that is, \u226411.3 pmol/L) (P <0.01). Three-month mortality was 14.5% (91/627) for patients with elevated copeptin compared to 3.2% (22/693) for patients with normal copeptin. Similar figures for one-year mortality and for the entire observation period were 27.6% (173/627) versus 8.7% (60/693) and 82.9% (520/527) versus 57.5% (398/693) (P <0.01 for both), respectively.Using multivariable Cox regression analyses shows that elevated copeptin was significantly and independently related to short-, mid- and long-term mortality. Adjusted hazard ratios were 2.4 for three-month mortality, 1.9 for one-year mortality and 1.4 for mortality in the entire observation period.\nIn patients admitted to an inner-city hospital, copeptin was strongly associated with short-, mid- and long-term mortality. The results suggest that rapid copeptin measurement could be a useful tool for both disposition in an emergency department and for mid- and long-term risk assessment.",
    "authors": [
        {
            "affiliation": "Departments of Cardiology and Endocrinology, Hiller\u00f8d Hospital, Hiller\u00f8d, Denmark. kasper.iversen@dadlnet.dk.",
            "firstname": "Kasper",
            "initials": "K",
            "lastname": "Iversen"
        },
        {
            "affiliation": null,
            "firstname": "Jens P",
            "initials": "JP",
            "lastname": "G\u00f8tze"
        },
        {
            "affiliation": null,
            "firstname": "Morten",
            "initials": "M",
            "lastname": "Dalsgaard"
        },
        {
            "affiliation": null,
            "firstname": "Henrik",
            "initials": "H",
            "lastname": "Nielsen"
        },
        {
            "affiliation": null,
            "firstname": "S\u00f8ren",
            "initials": "S",
            "lastname": "Boesgaard"
        },
        {
            "affiliation": null,
            "firstname": "Morten",
            "initials": "M",
            "lastname": "Bay"
        },
        {
            "affiliation": null,
            "firstname": "Vibeke",
            "initials": "V",
            "lastname": "Kirk"
        },
        {
            "affiliation": null,
            "firstname": "Olav W",
            "initials": "OW",
            "lastname": "Nielsen"
        },
        {
            "affiliation": null,
            "firstname": "Lars",
            "initials": "L",
            "lastname": "K\u00f8ber"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1186/1741-7015-12-80\n10.1136/bmj.d2983\n10.1373/clinchem.2005.060038\n10.1161/CIRCULATIONAHA.106.685503\n10.1016/j.jacc.2008.03.050\n10.1016/j.jacc.2010.05.049\n10.1212/WNL.0b013e31820b75e6\n10.1136/heartjnl-2011-300823\n10.1186/cc11671\n10.1136/heartjnl-2011-301269\n10.1161/CIRCULATIONAHA.111.063842\n10.1111/j.1747-4949.2011.00762.x\n10.1212/WNL.0b013e3182887944\n10.1016/j.amjcard.2012.11.053\n10.1001/jama.2011.666\n10.1186/1471-2377-10-34\n10.1016/j.peptides.2011.11.017\n10.1186/cc6780\n10.1097/MCP.0b013e3283218603\n10.1164/rccm.201003-0415OC\n10.1159/000319038\n10.1097/SHK.0b013e318033e5da\n10.1097/CCM.0b013e3181957532\n10.1007/s00134-008-1279-1\n10.1111/j.1553-2712.2011.01126.x\n10.1136/heart.89.2.150\n10.2174/1874241601205010021\n10.1016/j.jacc.2010.01.029\n10.1378/chest.06-2336\n10.1097/SHK.0b013e31817fd1d6",
    "journal": "BMC medicine",
    "keywords": [],
    "methods": "Consecutive patients >40-years-old admitted to an inner-city hospital were included. Within the first 24 hours after admission, a structured medical interview was conducted and self-reported medical history was recorded. All patients underwent a clinical examination, an echocardiographic evaluation and collection of blood for later measurement of risk markers.",
    "publication_date": "2014-06-03",
    "pubmed_id": "24884642\n23101886\n21632665\n16515430\n16269513\n18580851\n17420344\n18634981\n21070922\n21228295\n22194151\n23036303\n22337952\n22179538\n22336226\n23468541\n23276468\n21610241\n20504314\n22138140\n23407763\n18252006\n19532026\n20639437\n20639623\n17515850\n19114902\n18825368\n22386227\n21843221\n12527664\n23797027\n10389216\n20447532\n17426210\n16913350\n18650776",
    "results": "Plasma for copeptin measurement was available from 1,320 patients (average age 70.5 years, 59.4% women). Median follow-up time was 11.5 years (range 11.0 to 12.0 years). Copeptin was elevated (that is, above the 97.5 percentile in healthy individuals).Mortality within the first week was 2.7% (17/627) for patients with elevated copeptin (above the 97.5 percentile, that is, >11.3 pmol/L) compared to 0.1% (1/693) for patients with normal copeptin concentrations (that is, \u226411.3 pmol/L) (P <0.01). Three-month mortality was 14.5% (91/627) for patients with elevated copeptin compared to 3.2% (22/693) for patients with normal copeptin. Similar figures for one-year mortality and for the entire observation period were 27.6% (173/627) versus 8.7% (60/693) and 82.9% (520/527) versus 57.5% (398/693) (P <0.01 for both), respectively.Using multivariable Cox regression analyses shows that elevated copeptin was significantly and independently related to short-, mid- and long-term mortality. Adjusted hazard ratios were 2.4 for three-month mortality, 1.9 for one-year mortality and 1.4 for mortality in the entire observation period.",
    "title": "Risk stratification in emergency patients by copeptin.",
    "xml": "<Element 'PubmedArticle' at 0x7885060f5440>"
}