INTRODUCTION: The use of @entity1 recombinant activated protein C (rhAPC) for the treatment of @entity295 remains controversial despite multiple reported trials. The efficacy of rhAPC remains a matter of dispute. We hypothesized that @entity1 with @entity326 who were treated with rhAPC had an improved in-hospital mortality compared to @entity1 with @entity326 with similar acuity who did not receive rhAPC. METHODS: This retrospective cohort study was completed at a large university-affiliated hospital. All @entity1 with @entity326 admitted to a 50-bed ICU between July 2003 and February 2009 were included. @entity1 were treated according to sepsis management guidelines. RESULTS: A total of 563 @entity326 @entity1 were included (110 received rhAPC and 453 did not). Treated and untreated groups were matched in @entity1 characteristics, comorbidities, and physiologic variables in a 1:1 propensity-matched analysis (108 received rhAPC, 108 did not). Mean Acute Physiology And Chronic Health Evaluation II (APACHE II) scores were 24.5 for the matched treated and 23.9 for the matched untreated group (P = 0.54). Receipt of rhAPC was associated with reduced in-hospital mortality (35.2% vs. 53.8%, P = 0.005), similar mean days on vasopressors (2 vs. 2, P = 0.90), similar mean days on mechanical ventilation (9 vs. 8.7, P = 0.80), similar mean length of ICU stay in days (11.0 vs. 11.3, P = 0.90), and similar mean length of hospital stay in days (19.5 vs 27, P = 0.11). No @entity1 in either group had @entity510 ; differences in @entity360 and transfusion requirements were not statistically significant. CONCLUSIONS: @entity1 in our institution with @entity326 who were treated with rhAPC had a reduced in-hospital mortality compared with @entity1 with @entity326 with similar acuity who were not treated with rhAPC. In addition, time on mechanical ventilation, time on vasopressors, lengths of stay and @entity548 complications did not differ between the groups.

Activated protein C in XXXX : a propensity-matched analysis.

@entity1 :: ('9606', 'Species') :: ['Patients', 'human', 'patients', 'patient'] @entity295 :: ('MESH:D018805', 'Disease') :: ['severe sepsis'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity510 :: ('MESH:D013345', 'Disease') :: ['intracranial bleeding'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity360 :: ('MESH:D006471', 'Disease') :: ['gastrointestinal bleeding']
@entity326 :: (MESH:D012772,Disease) :: ['septic shock']
