Efficacy of blood copeptin level for the prediction of mortality of adult patients with sepsis: a meta-analysis.

Background: Copeptin, the C-terminal fragment of provasopressin, has emerged as a potential prognostic biomarker in sepsis. However, its predictive accuracy for mortality in adult patients with sepsis remains uncertain. We conducted a systematic review and meta-analysis to evaluate the diagnostic performance of elevated blood copeptin levels for mortality prediction in this population. Methods: We systematically searched PubMed, Embase, Web of Science, Wanfang Data, and CNKI from inception to 22 May 2025, for observational studies assessing copeptin levels at admission or within 48 h in adults with sepsis. Pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC) were calculated using a random-effects model. Study quality was assessed using QUADAS-2. Results: Ten prospective studies involving 1,637 patients were included. Pooled sensitivity and specificity of elevated copeptin for predicting mortality were 0.77 (95% CI: 0.70-0.83; I Conclusion: Elevated blood copeptin levels within 48 h of sepsis diagnosis show good prognostic accuracy for short-term mortality in adult patients with sepsis. These findings support the potential clinical utility of copeptin as a risk stratification tool in sepsis management. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024587540.