Estimate of the number of patients eligible for treatment with drotrecogin alfa (activated) based on differing international indications: Post-hoc analysis of an inception cohort study in Australia and New Zealand

Simon Finfer, T. Felton, A. Blundell, Jeff Lipman, Andrew Davies, Colin MacArthur, Lynette Newby, Rinaldo Bellomo, Donna Wise, Graham Reece, Felicity Hawker, Lorisa Soloveychik, James Nicholls, Seton Henderson, Andrew Bersten, Tamara Hunt, David Green, Brent Richards, Stuart Green, Tom Solano & 16 others Arthas Flabouris, Chris Joyce, Anthony Limpus, Jeff Lipman, Andrew Turner, Vlad Szachin, Maria Magnaye, Geoff Dobb, Eileen MacKenzie, Gordon Morris, Imogen Mitchell, Vernon van Heerden, Brigitte Roberts, Michael O'Leary, John Myburgh, Craig French

Research output: Contribution to journalArticleResearchpeer-review

Abstract

We aimed to estimate the potential number of patients eligible for treatment with drotrecogin alfa (activated) when applying different international criteria. The study was a post-hoc analysis of inception cohort study of 691 patients with severe sepsis during 5878 consecutive intensive care unit admission episodes in 23 closed multi-disciplinary ICUs of 21 hospitals (16 tertiary and 5 university-affiliated) in Australia and New Zealand. Outcomes assessed were presence of contraindications to treatment with drotrecogin alfa (activated), an admission APACHE II score of 25 or greater and dysfunction of two or more organs. During 5878 consecutive intensive care admission episodes, 691 patients had severe sepsis, 553 (80.0%, 95% CI 77.0-83.0%) had no relative or absolute contraindication, 64 (9.3%, 7.1-11.4%) had a relative contraindication and 74 (10.7%, 8.4-13.0%) had an absolute contraindication. Two hundred and six patients (3.5%, 3.0-4.0%) had an APACHE II score of 25 or greater, 452 (7.7%, 7.0-8.4%) had dysfunction of two or more organs, 469 (8.0%, 7.3-8.7%) had either dysfunction of two or more organs or an APACHE II score of 25 or greater. Relatively few patients had an absolute contraindication to treatment with drotrecogin alfa (activated). Selection based on the APACHE II score results in fewer eligible patients than selection based on multiple organ dysfunction. Depending on the selection criteria used, for every hundred admissions to intensive care, between 3.5 and 8.0 of patients may be eligible for treatment with drotrecogin alfa (activated).

Original languageEnglish
Pages (from-to)184-190
Number of pages7
JournalAnaesthesia and intensive care
Volume34
Issue number2
Publication statusPublished - 1 Apr 2006
Externally publishedYes

Keywords

  • Drotrecogin alfa (activated)
  • Sepsis
  • Therapy

Cite this

Finfer, Simon ; Felton, T. ; Blundell, A. ; Lipman, Jeff ; Davies, Andrew ; MacArthur, Colin ; Newby, Lynette ; Bellomo, Rinaldo ; Wise, Donna ; Reece, Graham ; Hawker, Felicity ; Soloveychik, Lorisa ; Nicholls, James ; Henderson, Seton ; Bersten, Andrew ; Hunt, Tamara ; Green, David ; Richards, Brent ; Green, Stuart ; Solano, Tom ; Flabouris, Arthas ; Joyce, Chris ; Limpus, Anthony ; Lipman, Jeff ; Turner, Andrew ; Szachin, Vlad ; Magnaye, Maria ; Dobb, Geoff ; MacKenzie, Eileen ; Morris, Gordon ; Mitchell, Imogen ; van Heerden, Vernon ; Roberts, Brigitte ; O'Leary, Michael ; Myburgh, John ; French, Craig. / Estimate of the number of patients eligible for treatment with drotrecogin alfa (activated) based on differing international indications : Post-hoc analysis of an inception cohort study in Australia and New Zealand. In: Anaesthesia and intensive care. 2006 ; Vol. 34, No. 2. pp. 184-190.
@article{2cab85fd667442459237e9f868c40d06,
title = "Estimate of the number of patients eligible for treatment with drotrecogin alfa (activated) based on differing international indications: Post-hoc analysis of an inception cohort study in Australia and New Zealand",
abstract = "We aimed to estimate the potential number of patients eligible for treatment with drotrecogin alfa (activated) when applying different international criteria. The study was a post-hoc analysis of inception cohort study of 691 patients with severe sepsis during 5878 consecutive intensive care unit admission episodes in 23 closed multi-disciplinary ICUs of 21 hospitals (16 tertiary and 5 university-affiliated) in Australia and New Zealand. Outcomes assessed were presence of contraindications to treatment with drotrecogin alfa (activated), an admission APACHE II score of 25 or greater and dysfunction of two or more organs. During 5878 consecutive intensive care admission episodes, 691 patients had severe sepsis, 553 (80.0{\%}, 95{\%} CI 77.0-83.0{\%}) had no relative or absolute contraindication, 64 (9.3{\%}, 7.1-11.4{\%}) had a relative contraindication and 74 (10.7{\%}, 8.4-13.0{\%}) had an absolute contraindication. Two hundred and six patients (3.5{\%}, 3.0-4.0{\%}) had an APACHE II score of 25 or greater, 452 (7.7{\%}, 7.0-8.4{\%}) had dysfunction of two or more organs, 469 (8.0{\%}, 7.3-8.7{\%}) had either dysfunction of two or more organs or an APACHE II score of 25 or greater. Relatively few patients had an absolute contraindication to treatment with drotrecogin alfa (activated). Selection based on the APACHE II score results in fewer eligible patients than selection based on multiple organ dysfunction. Depending on the selection criteria used, for every hundred admissions to intensive care, between 3.5 and 8.0 of patients may be eligible for treatment with drotrecogin alfa (activated).",
keywords = "Drotrecogin alfa (activated), Sepsis, Therapy",
author = "Simon Finfer and T. Felton and A. Blundell and Jeff Lipman and Andrew Davies and Colin MacArthur and Lynette Newby and Rinaldo Bellomo and Donna Wise and Graham Reece and Felicity Hawker and Lorisa Soloveychik and James Nicholls and Seton Henderson and Andrew Bersten and Tamara Hunt and David Green and Brent Richards and Stuart Green and Tom Solano and Arthas Flabouris and Chris Joyce and Anthony Limpus and Jeff Lipman and Andrew Turner and Vlad Szachin and Maria Magnaye and Geoff Dobb and Eileen MacKenzie and Gordon Morris and Imogen Mitchell and {van Heerden}, Vernon and Brigitte Roberts and Michael O'Leary and John Myburgh and Craig French",
year = "2006",
month = "4",
day = "1",
language = "English",
volume = "34",
pages = "184--190",
journal = "Anaesthesia and intensive care",
issn = "0310-057X",
publisher = "Australian Society of Anaesthetists",
number = "2",

}

Finfer, S, Felton, T, Blundell, A, Lipman, J, Davies, A, MacArthur, C, Newby, L, Bellomo, R, Wise, D, Reece, G, Hawker, F, Soloveychik, L, Nicholls, J, Henderson, S, Bersten, A, Hunt, T, Green, D, Richards, B, Green, S, Solano, T, Flabouris, A, Joyce, C, Limpus, A, Lipman, J, Turner, A, Szachin, V, Magnaye, M, Dobb, G, MacKenzie, E, Morris, G, Mitchell, I, van Heerden, V, Roberts, B, O'Leary, M, Myburgh, J & French, C 2006, 'Estimate of the number of patients eligible for treatment with drotrecogin alfa (activated) based on differing international indications: Post-hoc analysis of an inception cohort study in Australia and New Zealand' Anaesthesia and intensive care, vol. 34, no. 2, pp. 184-190.

Estimate of the number of patients eligible for treatment with drotrecogin alfa (activated) based on differing international indications : Post-hoc analysis of an inception cohort study in Australia and New Zealand. / Finfer, Simon; Felton, T.; Blundell, A.; Lipman, Jeff; Davies, Andrew; MacArthur, Colin; Newby, Lynette; Bellomo, Rinaldo; Wise, Donna; Reece, Graham; Hawker, Felicity; Soloveychik, Lorisa; Nicholls, James; Henderson, Seton; Bersten, Andrew; Hunt, Tamara; Green, David; Richards, Brent; Green, Stuart; Solano, Tom; Flabouris, Arthas; Joyce, Chris; Limpus, Anthony; Lipman, Jeff; Turner, Andrew; Szachin, Vlad; Magnaye, Maria; Dobb, Geoff; MacKenzie, Eileen; Morris, Gordon; Mitchell, Imogen; van Heerden, Vernon; Roberts, Brigitte; O'Leary, Michael; Myburgh, John; French, Craig.

In: Anaesthesia and intensive care, Vol. 34, No. 2, 01.04.2006, p. 184-190.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Estimate of the number of patients eligible for treatment with drotrecogin alfa (activated) based on differing international indications

T2 - Post-hoc analysis of an inception cohort study in Australia and New Zealand

AU - Finfer, Simon

AU - Felton, T.

AU - Blundell, A.

AU - Lipman, Jeff

AU - Davies, Andrew

AU - MacArthur, Colin

AU - Newby, Lynette

AU - Bellomo, Rinaldo

AU - Wise, Donna

AU - Reece, Graham

AU - Hawker, Felicity

AU - Soloveychik, Lorisa

AU - Nicholls, James

AU - Henderson, Seton

AU - Bersten, Andrew

AU - Hunt, Tamara

AU - Green, David

AU - Richards, Brent

AU - Green, Stuart

AU - Solano, Tom

AU - Flabouris, Arthas

AU - Joyce, Chris

AU - Limpus, Anthony

AU - Lipman, Jeff

AU - Turner, Andrew

AU - Szachin, Vlad

AU - Magnaye, Maria

AU - Dobb, Geoff

AU - MacKenzie, Eileen

AU - Morris, Gordon

AU - Mitchell, Imogen

AU - van Heerden, Vernon

AU - Roberts, Brigitte

AU - O'Leary, Michael

AU - Myburgh, John

AU - French, Craig

PY - 2006/4/1

Y1 - 2006/4/1

N2 - We aimed to estimate the potential number of patients eligible for treatment with drotrecogin alfa (activated) when applying different international criteria. The study was a post-hoc analysis of inception cohort study of 691 patients with severe sepsis during 5878 consecutive intensive care unit admission episodes in 23 closed multi-disciplinary ICUs of 21 hospitals (16 tertiary and 5 university-affiliated) in Australia and New Zealand. Outcomes assessed were presence of contraindications to treatment with drotrecogin alfa (activated), an admission APACHE II score of 25 or greater and dysfunction of two or more organs. During 5878 consecutive intensive care admission episodes, 691 patients had severe sepsis, 553 (80.0%, 95% CI 77.0-83.0%) had no relative or absolute contraindication, 64 (9.3%, 7.1-11.4%) had a relative contraindication and 74 (10.7%, 8.4-13.0%) had an absolute contraindication. Two hundred and six patients (3.5%, 3.0-4.0%) had an APACHE II score of 25 or greater, 452 (7.7%, 7.0-8.4%) had dysfunction of two or more organs, 469 (8.0%, 7.3-8.7%) had either dysfunction of two or more organs or an APACHE II score of 25 or greater. Relatively few patients had an absolute contraindication to treatment with drotrecogin alfa (activated). Selection based on the APACHE II score results in fewer eligible patients than selection based on multiple organ dysfunction. Depending on the selection criteria used, for every hundred admissions to intensive care, between 3.5 and 8.0 of patients may be eligible for treatment with drotrecogin alfa (activated).

AB - We aimed to estimate the potential number of patients eligible for treatment with drotrecogin alfa (activated) when applying different international criteria. The study was a post-hoc analysis of inception cohort study of 691 patients with severe sepsis during 5878 consecutive intensive care unit admission episodes in 23 closed multi-disciplinary ICUs of 21 hospitals (16 tertiary and 5 university-affiliated) in Australia and New Zealand. Outcomes assessed were presence of contraindications to treatment with drotrecogin alfa (activated), an admission APACHE II score of 25 or greater and dysfunction of two or more organs. During 5878 consecutive intensive care admission episodes, 691 patients had severe sepsis, 553 (80.0%, 95% CI 77.0-83.0%) had no relative or absolute contraindication, 64 (9.3%, 7.1-11.4%) had a relative contraindication and 74 (10.7%, 8.4-13.0%) had an absolute contraindication. Two hundred and six patients (3.5%, 3.0-4.0%) had an APACHE II score of 25 or greater, 452 (7.7%, 7.0-8.4%) had dysfunction of two or more organs, 469 (8.0%, 7.3-8.7%) had either dysfunction of two or more organs or an APACHE II score of 25 or greater. Relatively few patients had an absolute contraindication to treatment with drotrecogin alfa (activated). Selection based on the APACHE II score results in fewer eligible patients than selection based on multiple organ dysfunction. Depending on the selection criteria used, for every hundred admissions to intensive care, between 3.5 and 8.0 of patients may be eligible for treatment with drotrecogin alfa (activated).

KW - Drotrecogin alfa (activated)

KW - Sepsis

KW - Therapy

UR - http://www.scopus.com/inward/record.url?scp=33645759530&partnerID=8YFLogxK

M3 - Article

VL - 34

SP - 184

EP - 190

JO - Anaesthesia and intensive care

JF - Anaesthesia and intensive care

SN - 0310-057X

IS - 2

ER -