Differential effects of thiamine and ascorbic acid in clusters of septic patients identified by latent variable analysis
Authors' conclusion
These results reinforce the lack of efficacy of the combination of AA + B1 reported in recent trials and even raise concerns about potential harm in older patients with comorbidities. On the contrary, we reported improved ICU survival associated with B1 supplementation in the most severe patients and those with predominant respiratory failure
Study context
- Population
- Adults admitted to the ICU with sepsis or septic shock, January 2012–August 20225 clusters
- Participants
- 3,465 adults
- Exposure
- Standard treatment plus B1 or plus AA + B1 vs standard treatment, within patient clusters
- Controln = 2,183reference
- B1n = 1,054
- AA + B1n = 228
- Outcome
- In-hospital mortality within each cluster
Methodological detailsbi-centric, latent variable analysis, inverse probability weighted Cox models
- Bi-centric
- Latent variable analysis
- Inverse probability weighted Cox models
Main finding
As reported in the abstract
In-hospital mortality by cluster (subgroup)
- B1 associated with different outcomes across the five clusters
- B1 associated with lower in-hospital mortality in Cluster Severe and Cluster Resp
- AA + B1 not associated with reduced mortality in any cluster
- AA + B1 associated with increased mortality in Cluster Old
Observational data: associations, not effects.
Original publication
Differential effects of thiamine and ascorbic acid in clusters of septic patients identified by latent variable analysis. Crit Care. Published 29 November 2024. doi:10.
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