Value of copeptin and C-reactive protein in acute exacerbation of chronic obstructive pulmonary disease

Objectives: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) describes the phenomenon of sudden worsening in airway function and respiratory symptoms in patients with COPD. The aim of this work is to study the value of copeptin and C-reactive protein in AECOPD. Patients and methods: The study enrolled 31 patients with AECOPD and 10 control subjects. All patients were subjected to history taking, clinical examination, arterial blood gases analysis and sputum culture for bacteriological examination. Serum samples were obtained from the patients on admission, 3 days and 14 days after and from control subjects. The samples were analyzed for copeptin and CRP levels. Results: The copeptin level on admission was significantly higher in AECOPD patients than the control subjects. The copeptin and CRP showed a statistically significant decline over the study duration but did not correlate with each other. ROC analysis curve showed that a copeptin level > 14 pg/dl on admission had a sensitivity of 70% and specificity of 90% in predicting AECOPD and a level of > 15 pg/dl on the fourteenth day had a sensitivity of 100% and specificity of 90% in predicting in-hospital mortality. Copeptin correlated significantly directly with the presence of bacterial infection and inversely with both PaO2 and PaCO2. Neither the copeptin nor CRP correlated with the COPD severity as expressed by the FEV1%, BODE index and previous history of exacerbations. Conclusion: Copeptin has a good sensitivity and excellent specificity in predicting AECOPD. Additionally, it has good predilection for short term outcome and in-hospital mortality. (C) 2014 The Egyptian Society of Chest Diseases and Tuberculosis. Production and hosting by Elsevier B.V.