Relationship between blood copeptin levels and prognosis in gastrointestinal system bleeding

Gastrointestinal (GI) bleeding is a common cause of mortality and morbidity in the emergency department, and it also creates greater burden in terms of hospitalization and health expenditures compared to other GI problems. In this respect, it is very important to know the factors affecting the prognosis of GI bleeding, to predict the prognosis in order to have good treatment management. There are many classifications used in the literature to determine the prognosis of GI bleeding. The fact that these classifications are based on many parameters and that there are conflicting publications on these classifications shows the need for a new marker for prediction the outcome of GI bleeding. Copeptin is a peptide-structured molecule defined for the first time in 1972. It is released together with antidiuretic hormone (ADH) in an equimolar ratio to it. There are publications that this molecule is a successful biomarker in showing the prognosis in other disorders such as cardiovascular, pulmonary, neurological, and sepsis, that cause acute stress. In the literature, copeptin has been rarely studied in patients with GI bleeding. The aim of this study is to determine the blood copeptin levels in patients with GI bleeding and to show the relationship between copeptin levels and the amount of transfusion given to the patients, the prognosis of the patients and the prognostic scores associated with GI bleeding. This study, which has a prospective, cross-sectional, descriptive – analytical character, was carried out between June 2021 and May 2022 at Pamukkale University, Faculty of Medicine, Department of Emergency Medicine. Of the patients who met the inclusion criteria, 5 ml of venous blood sample was taken for serum copeptin level determination at the admission and the study form was filled. Demographic data, vital signs, other interventions (such as laboratory tests, endoscopy applications and blood products transfusion data) performed by the primary physicians were noted. The endpoints of the study were discharge, hospitalization (service or intensive care unit), poor outcome (mortality within 30 days). The relationship between the collected data and serum copeptin levels and endpoints was investigated. As a result of our study, there is no relationship between copeptin value and prognosis, the amount of transfusion and hospitalization status in patients with GI bleeding. Additionally, there is a significant relationship between shock index and the amount of transfusion administered during hospitalization and prognosis in these patients. We have found that the guidance of shock index in terms of prognosis is more successful than copeptin. Keywords: Copeptin, emergency department, gastrointestinal bleeding, mortality, prognosis