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Fig. 1 | Critical Care

Fig. 1

From: Association between urea trajectory and protein dose in critically ill adults: a secondary exploratory analysis of the effort protein trial (RE-EFFORT)

Fig. 1

Adapted from Oudenhoven et al.[5]

Urea trajectory for high and usual protein groups from the longitudinal sub-model (A), and schematic of treatment effects (B) from the joint model. The longitudinal sub-model (A) is a linear mixed effects model and includes an interaction term for time and treatment group with random intercepts and slopes. Time is modelled with a spline with three knots to account for nonlinearity of log-transformed urea values. Shown is a prediction plot with 95% prediction intervals. Predicted values are back-transformed for the plot. B is a schematic representation of the joint model. Time-varying indirect effect shows a strong relationship between high protein and increase in urea measurements over time. This association is combined with the effect estimate of the longitudinal marker on the survival outcome to summarise the indirect effect of the intervention on the survival outcome, through urea. The survival sub-model shows no direct effect of high protein on the survival outcome.

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Critical Care

ISSN: 1364-8535