Fig. 4

Confounder-adjusted, time-varying association of a medical nutrition therapy providing fewer vs more protein, with outcomes. Columns 1 and 4: Hypothetical medical nutrition therapy comparisons analyzing different levels of daily protein intake: low: < 0.8 g/kg; moderate: 0.8–1.2 g/kg; high: > 1.2 g/kg (Table 1). Columns 2 and 3, and 5 and 6: Corresponding time-varying associations of different hypothetical medical nutrition therapies with the hazard of successful weaning from invasive mechanical ventilation (IMV), or 90-day mortality. Gray areas indicate days with an identical protein intake. Due to specifications of the model, this intake could have been at any intake level. Solid lines indicate hazard ratios (HR), and hatched lines indicate corresponding 95% confidence intervals (CI). Reference medical nutrition therapy is the one which provides fewer protein [e.g., a HR (and 95% CI) < 1 would indicate a longer survival time but also a longer time until extubation associated with the medical nutrition therapy providing more protein]. Please note that HRs (and corresponding 95% CIs) must be 1 for the first 2 days for IMV and 4 days for survival due to the specification of the lag time, and also for time intervals, in which protein intake was identical within the relevant time window that affects the hazard. From the 90-day survival analysis, the HRs for the first 30 days are displayed due to estimation stability as the majority of deaths occurred until this day