Real-life use and outcomes of Drotrecogin alfa in the UK
Author Information
Author(s): Kathryn M Rowan, Catherine A Welch, Emma North, David A Harrison
Primary Institution: Intensive Care National Audit & Research Centre
Hypothesis
What are the real-life outcomes of Drotrecogin alfa (DrotAA) in patients with severe sepsis in the UK?
Conclusion
Drotrecogin alfa was used in a small proportion of severe sepsis cases, and its effectiveness was consistent with previous studies for patients with more severe disease.
Supporting Evidence
- 1,292 infusions of DrotAA were recorded across 112 units.
- Crude hospital mortality was high at 45%.
- Patients receiving DrotAA were younger and more severely ill compared to those who did not.
Takeaway
Doctors used a medicine called Drotrecogin alfa for very sick patients, but it didn't help everyone, especially those who weren't as sick.
Methodology
A nonrandomized audit linked DrotAA infusion data to case mix and outcome data from a national audit.
Potential Biases
Potential selection bias due to nonrandomized design and reliance on clinician-reported adverse events.
Limitations
The study was nonrandomized, which may introduce selection bias, and adverse event data were based on clinician opinion rather than standardized definitions.
Participant Demographics
Patients were predominantly nonsurgical, with a mean age of 58.8 years, and 90% were on mechanical ventilation.
Statistical Information
P-Value
0.85
Confidence Interval
0.62 to 0.81
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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