DOES SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT REDUCE MORTALITY FOR SEVERELY ILL PATIENTS

Objective: To investigate the relationship between baseline risk of de ath and reduced mortality after selective decontamination of the diges tive tract in intensive care unit patients, Design: Analysis of data f rom a meta analysis of 23 randomized, controlled trials, Patients: A t otal of 4,142 adult intensive care unit patients from the 23 trials, M easurements and Main Results: Mortality for patients receiving selecti ve decontamination of the digestive tract treatment was analyzed as a function of baseline risk of death at study entry, using weighted leas t squares regression across all 23 trials, In testing whether the slop e of the regression is different than 1.0, the observed t value is 3.3 2 (p < .004), suggesting that the efficacy of selective decontaminatio n of the digestive tract in reducing mortality is significantly better in populations at high mortality risk at study entry, Conclusions: Mo rtality reduction from selective decontamination of the digestive trac t appears related to the mortality risk of patients at the time of stu dy entry, Future trials should consider using baseline risk assessment as part of trial design and outcome analysis.