Does early goal-directed therapy reduce mortality among patients with severe sepsis or septic shock?
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Why is this study important?
The pooled estimate from study-level data of the 3 largest multi-center studies showed no difference in 90-day mortality between early goal directed therapy (EGDT) and standard sepsis care.[1] However, the substantial reduction in mortality for septic shock observed since the original EGDT study[2] has meant that contemporary attempts to examine that intervention likely would be under-powered and vulnerable to claims that sicker patients were not enrolled. This pre-planned analysis of pooled individual patient data from the 3 main trials was designed to mitigate the risk of bias and increase the power for a priori subgroup analyses.[3][4][5]
Which, if any, threats to validity are most likely to have an impact on the results and how?
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