Protein C as a Biomarker in Severe Sepsis
Author Information
Author(s): Andrew F. Shorr, David R. Nelson, Duncan L.A. Wyncoll, Konrad Reinhart, Frank Brunkhorst, George Matthew Vail, Jonathan Janes
Primary Institution: Washington Hospital Center
Hypothesis
Can protein C levels serve as a reliable biomarker for monitoring treatment response in severe sepsis patients receiving drotrecogin alfa?
Conclusion
Protein C is the only biomarker consistently correlated with treatment effect and survival in severe sepsis.
Supporting Evidence
- Protein C levels below 40% predict higher mortality in severe sepsis.
- Protein C was the only biomarker that explained over 50% of the treatment effect from drotrecogin alfa.
- Patients with normalized Protein C levels had lower mortality rates.
Takeaway
Protein C helps doctors understand how well patients with severe sepsis are doing and if they are responding to treatment.
Methodology
Analysis of data from two clinical trials (PROWESS and ENHANCE) involving severe sepsis patients treated with drotrecogin alfa.
Potential Biases
Potential bias due to the lack of prespecified clinically defined thresholds for biomarkers.
Limitations
This was a post hoc analysis limited to biomarkers measured during the PROWESS trial.
Participant Demographics
Mean age 60.5 years, 58% male, predominantly Caucasian.
Statistical Information
P-Value
0.04
Confidence Interval
95% CI for odds ratio 1.55–2.89
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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