Efficacy and Safety of Drotrecogin Alfa (Activated) for the Therapy of Surgical Patients with Severe Sepsis

Risk Models of Operative Morbidities in 16,930 Critically Ill Surgical Patients Based on a Japanese Nationwide Database

“…Severe sepsis/septic shock, defined as the presence of acute organ dysfunction in the context of infection, has a mortality rate of approximately 25% to 35%, 32 , 33 but which can exceed 70%. 34 , 35 Anaya and Nathens 36 analyzed risk factors of severe sepsis in 11,202 patients using Washington State administrative hospital discharge data.…”

Recombinant activated protein C usage in Scotland: a comparison with published guidelines and a survey of attitudes*

“…Despite the product licence's only excluding those who had undergone surgery in the previous 12 h or those for whom surgery was planned within the timing of infusion, the returned responses suggested that the 12‐h period was not of sufficient duration to minimise risk. In contrast to the opinion of a number of Scottish ICU consultants, safety studies in surgical patients suggest that the risk‐benefit profile would still favour the drug’s use in this context, despite the increased bleeding risk [20]. An alternative explanation may come from the collaborative nature of critical care medicine.…”

Advances in Surgical Critical Care

“…Several comparable studies have now been aggregated in the International Integrated Database for the Evaluation of Severe Sepsis and Drotrecogin alfa (activated) Therapy database, which shows a significant reduction in mortality rate (odds ratio ϭ 0.66; 95% CI ϭ 0.45 to 0.97) for therapy with APC of surgical patients with severe sepsis and a high risk of death. 110 However, the risk of bleeding is higher in those treated with APC. In contrast, surgical patients at a lower risk of death do not benefit from therapy with APC but are still placed at risk for bleeding.…”