Perioperative medicine & outcomes
Perioperative copeptin: predictive value and risk stratification in patients undergoing major noncardiac surgery—a prospective observational cohort study
Authors' conclusion
The results of the present prospective observational cohort study suggest that perioperative copeptin concentrations can help identify patients at risk for all-cause mortality and/or MACCE.
Study context
- Population
- Adults undergoing noncardiac surgery with intermediate to high surgical risk, Basel (Switzerland) and Düsseldorf (Germany), 2016–2020
- Participants
- 502 adults
- Exposure
- Elevated vs non-elevated perioperative copeptin
- Outcome
- Composite of:
- All-cause mortality
- MACCE
- Follow-up
- 12 months
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
All-cause mortality and/or MACCE
Hazard ratio (95% CI)
Elevated preoperative copeptinassociation persisted in multivariable analysis
2.89(1.62–5.2)
Elevated immediate postoperative copeptin
2.07(1.17–3.66)
Elevated copeptin on POD 2-4association persisted in multivariable analysis
2.47(1.36–4.46)
- Primary outcome event
- 48/502 (9.6%)
Observational data: associations, not effects.
Further findings
30-day major adverse cardiac and cerebrovascular events (MACCE) (elevated copeptin on POD 2-4)
| HR for MACCE (95% CI) | ||
|---|---|---|
| Elevated copeptin on POD 2-4Reported as association with 30-day MACCE-free survival | 2.15 (1.18–3.91) | |
| 0.20.5125HR for MACCE (log scale) |
Death and/or MACCE at 12 months, multivariable analysis
- Association persisted for preoperative copeptin and copeptin on POD 2-4
Perioperative myocardial injury (PMI)
- PMI
- 64 of 489 (13.1%)
- Elevated preoperative copeptin not associated with PMI; immediate postoperative copeptin modestly associated
Original publication
Perioperative copeptin: predictive value and risk stratification in patients undergoing major noncardiac surgery—a prospective observational cohort study. Can J Anaesth. Published 19 January 2024. doi:10.
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