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Table 3 Relative measures of diagnostic accuracy for different outcomes

From: Serum Copeptin levels in the emergency department predict major clinical outcomes in adult trauma patients

Biomarker

Cut-off

Primary outcome ISS > 15

  

Sensitivity (95%CI)

Specificity (95%CI)

+LR (95%CI)

-LR (95%CI)

Lactate

URL

2 mmol/L

0.64 (0.51–0.76)

0.63 (0.50–0.74)

1.7 (1.2–2.5)

0.58 (0.4–0.8)

MYI

1.61 mmol/L

0.82 (0.70–0.91)

0.48 (0.36–0.61)

1.59 (1.2–2.1)

0.37 (0.2–0.7)

95% Sens

0.80 mmol/L

N/A

0.14 (0.00–0.28)

1.11 (1.0–1.2)

0.35 (0.10–1.2)

Copeptin

MYI

189 pmol/L

0.72 (0.59–0.83)

0.86 (0.75–0.93)

5.13 (2.7–9.6)

0.32 (0.2–0.5)

95% Sens

12.4 pmol/L

N/A

0.20 (0.51–0.48)

1.19 (1.0–1.4)

0.24 (0.07–0.8)

Secondary outcome hospital admission

  

Sensitivity (95%CI)

Specificity (95%CI)

+LR (95%CI)

-LR (95%CI)

Lactate

URL

2 mmol/L

0.53 (0.43–0.63)

0.73 (0.45–0.92)

1.98 (0.8–4.7)

0.64 (0.4–0.9)

MYI

2.60 mmol/L

0.38 (0.29–0.48)

0.93 (0.68–0.99)

5.69 (0.8–38.4)

0.66 (0.5–0.8)

95% Sens

0.75 mmol/L

N/A

0.13 (0.02–0.41)

1.06 (0.9–1.3)

0.59 (0.1–2.5)

Copeptin

MYI

31 pmol/L

0.84 (0.76–0.91)

0.73 (0.45–0.92)

3.16 (1.4–7.3)

0.21 (0.1–0.4)

95% Sens

8.1 pmol/L

N/A

0.27 (0.00–0.60)

1.29 (0.9–1.8)

0.21 (0.07–0.7)

Secondary outcome blood transfusion

  

Sensitivity (95%CI)

Specificity (95%CI)

+LR (95%CI)

-LR (95%CI)

Lactate

URL

2 mmol/L

0.67 (0.41–0.87)

0.53 (0.43–0.63)

1.43 (1.0–2.1)

0.63 (0.3–1.2)

MYI

1.67 mmol/L

0.89 (0.65–0.99)

0.45 (0.35–0.55)

1.61 (1.3–2.0)

0.25 (0.07–0.9)

95% Sens

1.19 mmol/L

N/A

0.21 (0.08–0.42)

1.19 (1.0–1.4)

0.27 (0.04–1.8)

Copeptin

MYI

291 pmol/L

0.83 (0.59–0.96)

0.79 (0.70–0.86)

3.98 (2.6–6.1)

0.21 (0.07–0.6)

95% Sens

94.4 pmol/L

N/A

0.49 (0.35–0.64)

1.84 (1.5–2.3)

0.11 (0.02–0.8)

Secondary outcome ICU admission

  

Sensitivity (95%CI)

Specificity (95%CI)

+LR (95%CI)

-LR (95%CI)

Lactate

URL

2 mmol/L

0.76 (0.57–0.90)

0.59 (0.48–0.69)

1.83 (1.3–2.5)

0.41 (0.2–0.8)

MYI

1.64 mmol/L

0.97 (0.82–0.99)

0.48 (0.38–0.58)

1.85 (1.5–2.3)

0.07 (0.01–0.5)

95% Sens

1.65 mmol/L

N/A

0.48 (0.17–0.64)

1.85 (1.5–2.3)

0.07 (0.01–0.5)

Copeptin

MYI

400 pmol/L

0.66 (0.46–0.82)

0.90 (0.83–0.96)

6.84 (3.5–13.4)

0.38 (0.2–0.6)

95% Sens

61.5 pmol/L

N/A

0.43 (0.03–0.67)

1.68 (1.4–2.0)

0.08 (0.01–0.6)

Secondary outcome emergency surgery

  

Sensitivity (95%CI)

Specificity (95%CI)

+LR (95%CI)

-LR (95%CI)

Lactate

URL

2 mmol/L

0.64 (0.35–0.87)

0.52 (0.43–0.62)

1.35 (0.9–2.1)

0.68 (0.3–1.4)

MYI

2.78 mmol/L

0.64 (0.35–0.87)

0.76 (0.67–0.84)

2.7 (1.6–4.5)

0.47 (0.2–1.0)

95% Sens

1.18 mmol/L

N/A

0.20 (0.08–0.40)

1.16 (1.0–1.4)

0.35 (0.05–2.4)

Copeptin

MYI

132 pmol/L

1.00 (0.77–1.00)

0.58 (0.48–0.67)

2.37 (1.9–3.0)

0

95% Sens

146 pmol/L

N/A

0.58 (0.47–0.67)

2.2 (1.7–2.9)

0.12 (0.02–0.8)

  1. Relative measures of diagnostic accuracy (sensitivity, specificity, likelihood ratios) for different cut-offs of lactate and copeptin for primary and secondary outcomes are reported: the limit associated with maximum value of Youden Index and one with high (95%) sensitivity are shown; for lactate, also the upper reference limit (2 mmol/L) is reported. Youden’s J statistics summarizes the diagnostic performance of a test relative to a given cut-off: its value ranges from 0 for non-informative tests to 1 for perfect tests. Cut-off values are in mmol/L (lactate) and pmol/L (copeptin). URL Upper reference limit, MYI Maximum Youden Index. 95%Sens Sensitivity of 95%, CI Confidence intervals, +LR Positive likelihood ratio, -LR Negative likelihood ratio, N/A Not applicable
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