methods Archives - Critical Care Science (CCS)

  • Original Article

    Alternative approaches to analyzing ventilator-free days, mortality and duration of ventilation in critical care research

    Crit Care Sci. 2024;36:e20240246en

    Abstract

    Original Article

    Alternative approaches to analyzing ventilator-free days, mortality and duration of ventilation in critical care research

    Crit Care Sci. 2024;36:e20240246en

    DOI 10.62675/2965-2774.20240246-en

    Views114

    ABSTRACT

    Objective:

    To discuss the strengths and limitations of ventilator-free days and to provide a comprehensive discussion of the different analytic methods for analyzing and interpreting this outcome.

    Methods:

    Using simulations, the power of different analytical methods was assessed, namely: quantile (median) regression, cumulative logistic regression, generalized pairwise comparison, conditional approach and truncated approach. Overall, 3,000 simulations of a two-arm trial with n = 300 per arm were computed using a two-sided alternative hypothesis and a type I error rate of α = 0.05.

    Results:

    When considering power, median regression did not perform well in studies where the treatment effect was mainly driven by mortality. Median regression performed better in situations with a weak effect on mortality but a strong effect on duration, duration only, and moderate mortality and duration. Cumulative logistic regression was found to produce similar power to the Wilcoxon rank-sum test across all scenarios, being the best strategy for the scenarios of moderate mortality and duration, weak mortality and strong duration, and duration only.

    Conclusion:

    In this study, we describe the relative power of new methods for analyzing ventilator-free days in critical care research. Our data provide validation and guidance for the use of the cumulative logistic model, median regression, generalized pairwise comparisons, and the conditional and truncated approach in specific scenarios.

    See more
  • Original Articles - Clinical Research

    Nutritional status, hyperglycemia, early nutrition, and mortality of patients hospitalized in an intensive care unit

    Rev Bras Ter Intensiva. 2012;24(2):157-161

    Abstract

    Original Articles - Clinical Research

    Nutritional status, hyperglycemia, early nutrition, and mortality of patients hospitalized in an intensive care unit

    Rev Bras Ter Intensiva. 2012;24(2):157-161

    DOI 10.1590/S0103-507X2012000200010

    Views0

    OBJECTIVE: Because patients hospitalized in intensive care units are at risk for poor nutrition, and nutritional therapy is not always started at an appropriate time, the present study aimed to correlate nutritional status, early nutrition, and hyperglycemia with patient mortality in an intensive care unit. METHODS: This archival cohort study used the secondary database of 453 patients who stayed at least 48 hours in an intensive care unit and were assessed for 8 days of hospitalization. Patient nutritional status was defined according to the body mass index. Early nutrition was defined as an feeding energy within the first 48 hours of hospitalization, regardless of the administration route. Blood glucose levels were monitored using a glucometer. RESULTS: A majority of patients were male (54.2%), and approximately half of patients were overweight (48.4%). At the end of the first 48 hours, 69.4% of patients had received nutrition, and only 13.5% of patients still exhibited hyperglycemia. The patients who received early nutritional therapy exhibited lower a mortality risk (p = 0.002), regardless of the presence of other factors associated with mortality. CONCLUSIONS: The significant correlation between early nutritional therapy and survival emphasizes the importance of nutrition in severely ill patients. The low frequency of hyperglycemia found in this study might indicate that the prescription of nutritional therapy and the application of an insulin protocol are appropriate at institutional intensive care units.

    See more

Search

Search in:

Article type
article-commentary
brief-report
case-report
correction
editorial
editorial
letter
letter
other
rapid-communication
reply
research-article
review-article
review-article
Section
Articles
Artigo de Revisão de Pediatria
Artigo Original
Artigo Original de Pediatria
Artigo Original Destaque
Artigos de Revisão
Artigos de Revisão
Artigos originais
Author's Response
Brief Communication
Case Report
Case Reports
Clinical Report
Comentários
Commentaries
Commentary
Consenso Brasileiro de Monitorização e Suporte Hemodinâmico
Correspondence
Editoriais
Editorial
Editorials
Erratum
Letter to the Editor
Letters to the Editor
Original Article
Original Article - Basic Research
Original Article - Neonatologia
Original Articles
Original Articles - Basic Research
Original Articles - Clinical Research
Relato de Caso
Relatos de Caso
Research Letter
Review
Review Article
Special Article
Special Articles
Viewpoint
Year / Volume
2024; v.36
2023; v.35
2022; v.34
2021; v.33
2020; v.32
2019; v.31
2018; v.30
2017; v.29
2016; v.28
2015; v.27
2014; v.26
2013; v.25
2012; v.24
2011; v.23
2010; v.22
2009; v.21
2008; v.20
2007; v.19
2006; v.18
ISSUE