ArticleIntensive care medicine2007
Evaluating the use of Drotrecogin alfa (activated) in adult severe sepsis: a Canadian multicenter observational study.
Article in Intensive care medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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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.
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.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Human recombinant protein C for severe sepsis and septic shock in adult and paediatric patients.The Cochrane database of systematic reviews · 2012Pooled it
- Comprehensive safety analysis of concomitant drotrecogin alfa (activated) and prophylactic heparin use in patients with severe sepsis.Intensive care medicine · 2009Trial
- Pharmacogenomic biomarkers do not predict response to drotrecogin alfa in patients with severe sepsis.Annals of intensive care · 2018Article
- Evaluation of recombinant activated protein C for severe sepsis at a tertiary academic medical center.Therapeutics and clinical risk management · 2013Article
- Design, conduct, and analysis of a multicenter, pharmacogenomic, biomarker study in matched patients with severe sepsis treated with or without drotrecogin Alfa (activated).Annals of intensive care · 2012Article
- An update on activated protein C (xigris) in the management of sepsis.P & T : a peer-reviewed journal for formulary management · 2010Article
- Protective mechanisms of activated protein C in severe inflammatory disorders.British journal of pharmacology · 2009Review
- Hemodynamic resuscitation in septic shock: cardiovascular support and adjunctive therapy.Current infectious disease reports · 2009Article
- The international PROGRESS registry of patients with severe sepsis: drotrecogin alfa (activated) use and patient outcomes.Critical care (London, England) · 2009Article
- Growing insights into the potential benefits and risks of activated protein C administration in sepsis: a review of preclinical and clinical studies.Biologics : targets & therapy · 2009Article
- Early drotrecogin alpha (activated) administration in severe sepsis is associated with lower mortality: a retrospective analysis of the Canadian ENHANCE cohort.Critical care (London, England) · 2009Article
- Scientific and clinical challenges in sepsis.Current pharmaceutical design · 2009Review
- Dissociation of activated protein C functions by elimination of protein S cofactor enhancement.The Journal of biological chemistry · 2008Article
- Editors' comments on a new trial of activated protein C for persistent septic shock.Intensive care medicine · 2008Article
- Once is not enough: clinical trials in sepsis.Intensive care medicine · 2008Article
- Use of recombinant human activated protein C in patients with severe sepsis: a French retrospective multicentre study.Intensive care medicine · 2008Article
- Neuropeptide modulators of high mobility group box 1 secretion as potential therapeutic agents for severe sepsis.The American journal of pathology · 2008Article
- Year in review in Intensive Care Medicine, 2007. II. Haemodynamics, pneumonia, infections and sepsis, invasive and non-invasive mechanical ventilation, acute respiratory distress syndrome.Intensive care medicine · 2008Review
- Increased bleeding risk associated with the use of recombinant human activated protein C in patients with advanced liver disease.Critical care (London, England) · 2008Article
- Drotrecogin alfa (activated): real-life use and outcomes for the UK.Critical care (London, England) · 2008Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe purpose of this study was to characterize the usage patterns and clinical outcomes of DAA in Ontario and Quebec over a 1-year period.
methodsAll hospitals with DAA on formulary in Ontario and Quebec were invited to participate. Consecutive patients who received DAA from 1 March 2003 to 29 February 2004 were identified retrospectively. Demographic, treatment, and outcome variables were collected via chart review. Descriptive statistics on relevant variables were performed, along with logistic regression to determine relevant risk factors for survival and bleeding.
resultsThirty-seven sites participated with a total of 261 courses of DAA administered. The overall mortality rate was 45%; age (> 65 years), multiple organ system failure (> 3), and nosocomial source of sepsis were predictors of mortality, whereas early DAA administration (< 12 h) was associated with lower mortality. Serious bleeding events occurred in 10% of the patients. Only 1 case (0.4%) of fatal intracranial bleed was observed. Multiple organ system failure (>/= 4)and relative contraindications to DAA were predictors of bleeding events.
interpretationMortality and bleeding complications associated with the use of DAA were higher than that reported in randomized trials but similar to other usage database. This may be due to the higher severity of illness seen in this cohort of patients. Modifiable risks associated with mortality and bleeding, such as time to treatment, and knowledge of relative contraindications should be targets of further research and future educational efforts in order to optimize the risk-to-benefit ratio of DAA.
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Registered trials
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.