Journal Club Summary

Methodology Score: 4.5                   
Usefulness Score: 4.5
Asfar P, Meziani F, Hamel JF, Grelon F, Megarbane B, Anguel N, et al. for the SEPSISPAM Investigators. N Engl J Med. 2014 Apr 24;370(17):1583-93
This multi-centre, randomized, open-label trial found no significant difference in 28-day mortality, 90- day mortality or overall adverse events when comparing a low target MAP (65- 70 mmHg) to a high target MAP (80-85 mmHg) in septic shock patients. (34% vs 36.6%, HR 1.07, p =0.57, 95%CI 0.84 – 1.38). JC Attendees agreed that this study had a robust methodology, addressed an important question and could readily be extrapolated to the emergency department setting, in confirming that precise targeting of MAP is likely not going to affect mortality outcomes.  
By: Dr. Layli Sanaee
(Presented October 2014)

Epi lesson: Survival Analyses   

Survival analyses are used in clinical trials that follow patients over time for primary outcomes such as death, relapse, adverse drug reaction, or development of a new disease. The follow-up time may range from hours to years and a different set of statistical procedures are employed to analyze the data. Terms frequently seen in papers with survival analyses include Cox proportional hazard model, hazard ratio, Kaplan-Meier curve. 
By: Dr. Ian Stiell