Protein C Levels and Sepsis Outcomes
Author Information
Author(s): Andrew F Shorr, Gordon R Bernard, Jean-Francois Dhainaut, James R Russell, William L Macias, David R Nelson, David P Sundin
Primary Institution: Washington Hospital Center
Hypothesis
Early directional changes in protein C levels correlate with outcome in severe sepsis patients.
Conclusion
Baseline protein C levels and changes by day 1 are independent predictors of sepsis outcomes.
Supporting Evidence
- Severely deficient protein C levels at baseline were associated with higher mortality.
- Improvement in protein C levels by day 1 significantly reduced mortality risk.
- DrotAA treatment increased protein C levels and improved survival in severely deficient patients.
Takeaway
If a sick person has low protein C levels, it can mean they might not get better. Watching how these levels change can help doctors know who is at risk.
Methodology
Patients from the PROWESS trial were assessed for protein C levels and categorized by deficiency status, with logistic regression used to analyze mortality risk.
Potential Biases
Potential bias due to exclusion of patients at high risk of bleeding.
Limitations
Exclusion criteria may have led to an underestimation of the prevalence of low protein C levels; analyses were mostly retrospective.
Participant Demographics
Patients were adults with severe sepsis from 164 sites in 11 countries.
Statistical Information
P-Value
P < 0.0001
Confidence Interval
95% CI for odds ratios provided in results
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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