Protein C levels can be forecasted by global haemostatic tests in critically ill patients and predict long-term survival

Treatment of the critically ill patient with protein C: Is it worth the cost?

“…Including protein C as a continuous, as well as a categorical variable, in the Cox proportional hazards model, resulted in a statistically significant effect on the hazard for each time-horizon (30 and 180 days, and one and five years), confirming the results in [7]. However, when separating patients into subgroups defined by the cutpoint, and running separate regressions for each subgroup with protein C as a continuous variable, no statistically significant effect was found (results available from authors on request).…”

“…Inclusion criteria were, irrespective of causative background diagnosis, one or more of the following global haemostatic test results: platelet count <100 × 10 9 L -1 , INR >1.36, APTT >45 s [7]. The study which the current calculations are based on was approved by the Ethics Committee, Lund University.…”

“…Our data include readings of platelet count, International Normalized Ratio (INR), Activated Partial Thromboplastin Time (APTT), protein C, and antithrombin within twelve hours after admission to the ICU [7]. These variables are all expected to return to normal levels when the patient recovers from the coagulation disturbance after the "acute" period.…”

“…We experimented with two different ways of including the protein C variable: (1) as a continuous variable, and (2) as a dichotomous variable according to cutpoint 0.39 IU/mL as described [7]. We also separated the patients into two groups according to the cutpoint, and estimated the Cox model separately for each group including protein C as a continuous variable.…”

“…We have shown that low protein C levels at admission to a main intensive care unit (ICU) predict poor long-term survival up to 5 years [7]. In the present study, the objective was to calculate the costs of treatment with protein C per statistical life saved.…”