Copeptin level in chronic obstructive pulmonary disease acute exacerbation and relation between mortality

COPEPTIN LEVEL IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE ACUTE EXACERBATION AND RELATION BETWEEN MORTALITY Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease of airways and lung paranchyma. Clinical course in COPD patients during acute attack get worse than stabil period. Copeptin is a glicopeptid that is related with arginin-vazopressin (AVP). Copeptin is released by so many physiological and pathological stimulus like pain, infection, hypoxemia, exercise, hypoglisemia, stroke, and shock. It is aimed to determine the serum copeptin levels in COPD patients with acute attack, relation between copeptin and variable inflammatory biomarkers, arterial blood gas, pulmonary function test parameters, moreover it is aimed to determine the nonsurvivor patients within 6 months after attack, and to describe any realtion between copeptin level and mortality. Demographic data, arterial blood gas, and pulmonary function test parameters of 70 COPD patients with acute attack who are hospitalized to our clinic were recorded. Forty cases who have similiar age and sex with patients were accepted as control group. Venous blood samples for determining copeptin levels were taken in patients and control group before starting attack therapy. Of COPD patients included to the study, 61 were male, 9 were female, mean age was 66.21±6.59, 32 of control group were male, 8 were female, and mean age was 63.77±5.26. There was no significant statistical difference in age and sex between two groups (χ2 =0.994, p>0.05). Body mass index also showed no difference between groups (25.48±6.28 in COPD group, 24.48±3.72 in control group, p>0.05). Disease duration in COPD patients was 5.8±4.17 year, hospitalization duration was 5.65±3.93 days. Serum copeptin levels were significantly higher in COPD group than control group (7.25±2.39 in COPD group, 5.69±2.06 in control group, p=0.002). When COPD patients grouped as; using LTOT/not using LTOT, having comorbidity or not, hospitalization number 1 or ≥2, it is determined that copeptin levels did not show any difference between groups (p>0.05). When mortality rate was investigated in hospitalized COPD patients with acute attack, it was seen that mortality rate within 6 month after discharge was 12.85% (n=9). Demographic data of survivor and nonsurvivor patients showed only significant difference in number of attack (p=0.001). Moreover, PaCO2 levels were significantly higher, and SaO2 levels were significantly lower in nonsurvivor patients than surviviors (p=0.004, p=0.021, respectively) Relation between serum copeptin levels and demographic and laboratory data showed that; copeptin levels were negatively correlated with FEV1 and PaO2 levels (r=-0.350, p=0.003, r=-0.276, p=0.026, respectively). It can be said that copeptin may be a useful parameter to predict airway obstruction and hypoxemia severity, because its level increased during COPD attack, and showed negative correlation between FEV1 and PaO2. Key words: COPD acute exacerbation, copeptin, mortality