Association between urea trajectory and protein dose in critically ill adults: a secondary exploratory analysis of the effort protein trial (RE-EFFORT)
Primary result · Death at 30 days per twofold rise in ureaResult — go to the resultHazard ratio 1.34 95% CrI 1.21–1.48Authors' conclusion
The increased risk of death in patients randomised to a higher protein dose in the EFFORT Protein trial was estimated to be mediated by increased urea cycle activity, of which serum urea is a biological signature.
Study context
- Population
- Mechanically ventilated critically ill adultsof 1301 in EFFORT Protein
- Participants
- 1,277 participants
- Comparison
- Higher vs usual protein dose; association of urea trajectory with 30-day survival
- Primary endpoint
- Association of urea with 30-day survival
- Follow-up
- 30 days
Methodological detailsexploratory, Bayesian joint models
- Exploratory
- Bayesian joint models
Primary result
Death at 30 days per twofold rise in urea
Hazard ratio
1.34
95% CrI 1.21–1.48
Twofold rise in urea
HR 1.34 (95% CrI 1.21–1.48)
Per twofold rise in urea, as printed
As reported in the abstract
Further findings
Median urea, high protein vs comparator · day 6
| Difference (mmol/L) (95% CI) | ||
|---|---|---|
| High protein | 2.1 (1.1–3.2) | |
| −2024Difference, mmol/L (linear scale) |
Median urea, high protein vs comparator · day 12
| Difference (mmol/L) (95% CI) | ||
|---|---|---|
| High protein | 3.0 (1.3–4.7) | |
| −20246Difference, mmol/L (linear scale) |
Deaths at 30 days post-randomisation
- Deaths
- 344
Original publication
Association between urea trajectory and protein dose in critically ill adults: a secondary exploratory analysis of the effort protein trial (RE-EFFORT). Crit Care. Published 16 January 2024. doi:10.
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