Evidence map›Paper›PMID 17111246›Full record

ArticlePharmacy world & science : PWS2006

Evaluation of drotrecogin alpha use in a Belgian university hospital.

Isabel Spriet, Wouter Meersseman, Alexander Wilmer, Geert Meyfroidt, Minne Casteels, Ludo Willems

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Article in Pharmacy world & science : PWS, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors.

Isabel SprietPharmacy Department, University Hospital of Leuven, Herestraat 49, Leuven, 3000, Belgium. isabel.spriet@uz.kuleuven.ac.be
Wouter Meersseman
Alexander Wilmer
Geert Meyfroidt
Minne Casteels
Ludo Willems

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSepsis remains a major cause of mortality in ICU patients, despite advances in therapy. Drotrecogin alpha (Drot AA), a recombinant human activated protein C with anti-inflammatory and anticoagulant properties, has proven to be successful in patients with at least one organ failure. Our goal was to evaluate the data in patients with sepsis and at least two organ dysfunctions in a large university hospital in Belgium.

settingThe study was conducted at the medical and surgical intensive care units of the 1850-bed university hospital of Leuven, Belgium.

methodsWe retrospectively evaluated the use of Drot AA during a 2.5 year period. At baseline patients' demographics, type of infection, APACHE II (acute physiology and chronic health evaluation), SOFA (sequential organ failure assessment), DIC (diffuse intravascular coagulation) score and number of organ failures were obtained. Overall hospital mortality was defined as primary outcome measure. Special attention was paid to bleeding, the main side effect of Drot AA.

main outcome measureEvalution of hospital and ICU mortality in patients treated with Drot AA for severe sepsis.

resultsDrot AA was administered to 23 patients with sepsis and at least 2 organ dysfunctions; all patients started treatment within 24 h of onset of the second organ failure. Mean age was 59 years. Mean number of organ failures was 3. Overall hospital mortality rate was 47.8%. A 28-day mortality of 26% was found, comparable with the 28-day mortality rate of the PROWESS trial. Bleeding, requiring more than 3 units of blood, occurred in 1 patient. Although underlying co-morbidity was more pronounced in survivors, non-survivors had a slightly higher median APACHE II, higher SOFA score and higher DIC score. However, the number of organ failures was identical in both groups.

conclusionsOverall hospital mortality rate was similar as observed in the Belgian Registry and 28-day mortality was equal to the results of the PROWESS study. Due to the limited number of patients, it is not clear if patients should be selected based on APACHE II, DIC or number of organ failures. However, selection based on number of organ failures is more appropriate due to intrinsic problems of the APACHE II score.

Indexed as

Hospitals, UniversityAdultAgedAged, 80 and overBelgiumFemaleHumansMaleMiddle AgedProtein CRecombinant ProteinsRetrospective StudiesTreatment Outcomedrotrecogin alfa activatedProtein CRecombinant Proteins

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.