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Published on: June 12, 2021
Activated protein C in septic shock: a propensity-matched analysis.
Farid Sadaka1, Jacklyn O'Brien, Matthew Migneron
1St. John's Mercy Medical Center/St Louis University, 621 S New Ballas Rd., Suite 4006B, St. Louis, MO 63141, USA. farid.sadaka@mercy.net
Critical Care (London, England)
|March 10, 2011
Summary
Human recombinant activated protein C (rhAPC) treatment for septic shock patients was associated with lower in-hospital mortality. This study found no significant differences in ventilation, vasopressor use, or length of stay between treated and untreated groups.
Area of Science:
- Critical Care Medicine
- Pharmacology
- Sepsis Research
Background:
- The efficacy of human recombinant activated protein C (rhAPC) in treating severe sepsis is debated.
- Previous trials on rhAPC for sepsis have yielded controversial results.
- This study investigates the impact of rhAPC on mortality in septic shock patients.
Purpose of the Study:
- To evaluate the in-hospital mortality rate of septic shock patients treated with rhAPC.
- To compare outcomes between septic shock patients who received rhAPC and those who did not.
- To assess the association of rhAPC with mortality, resource utilization, and bleeding complications.
Main Methods:
- Retrospective cohort study of 563 septic shock patients in a university-affiliated ICU (July 2003-February 2009).
- 1:1 propensity-matched analysis comparing 108 patients treated with rhAPC to 108 untreated patients.
- Matched groups had similar acuity (APACHE II scores), comorbidities, and physiological variables.
Main Results:
- rhAPC treatment was linked to significantly reduced in-hospital mortality (35.2% vs. 53.8%, P=0.005).
- No significant differences were observed in mean days on vasopressors (2 vs. 2), mechanical ventilation (9 vs. 8.7), ICU stay (11.0 vs. 11.3), or hospital stay (19.5 vs. 27).
- No significant differences in intracranial, gastrointestinal bleeding, or transfusion requirements between groups.
Conclusions:
- Septic shock patients treated with rhAPC at this institution experienced lower in-hospital mortality.
- rhAPC treatment did not significantly affect mechanical ventilation duration, vasopressor use, length of stay, or bleeding complications.
- These findings suggest a potential benefit of rhAPC in reducing mortality for septic shock patients.
