دورية أكاديمية
A Bayesian reanalysis of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial
| العنوان: | A Bayesian reanalysis of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial |
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| المؤلفون: | Zampieri Fernando G, da Costa Bruno R, Vaara Suvi T, Lamontagne François, Rochwerg Bram, Nichol Alistair D, McGuinness Shay, McAuley Danny F, Ostermann Marlies, Wald Ron, Bagshaw Sean M, STARRT-AKI Investigators, Landoni G, Zangrillo A |
| المساهمون: | Zampieri Fernando, G, da Costa Bruno, R, Vaara Suvi, T, Lamontagne, Françoi, Rochwerg, Bram, Nichol Alistair, D, Mcguinness, Shay, McAuley Danny, F, Ostermann, Marlie, Wald, Ron, Bagshaw Sean, M, STARRT-AKI, Investigator, Landoni, G, Zangrillo, A |
| بيانات النشر: | BMC |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Acute kidney injury, Bayesian, Dialysis, Kidney-replacement therapy, Mortality, Randomized, Trial, Bayes Theorem, Humans, Probability, Renal Replacement Therapy, Critical Illness |
| الوصف: | Background Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial compared two strategies of KRT initiation (accelerated versus standard) in critically ill patients with acute kidney injury and found neutral results for 90-day all-cause mortality. Probabilistic exploration of the trial endpoints may enable greater understanding of the trial findings. We aimed to perform a reanalysis using a Bayesian framework. Methods We performed a secondary analysis of all 2927 patients randomized in multi-national STARRT-AKI trial, performed at 168 centers in 15 countries. The primary endpoint, 90-day all-cause mortality, was evaluated using hierarchical Bayesian logistic regression. A spectrum of priors includes optimistic, neutral, and pessimistic priors, along with priors informed from earlier clinical trials. Secondary endpoints (KRT-free days and hospital-free days) were assessed using zero-one inflated beta regression. Results The posterior probability of benefit comparing an accelerated versus a standard KRT initiation strategy for the primary endpoint suggested no important difference, regardless of the prior used (absolute difference of 0.13% [95% credible interval [CrI] - 3.30%; 3.40%], - 0.39% [95% CrI - 3.46%; 3.00%], and 0.64% [95% CrI - 2.53%; 3.88%] for neutral, optimistic, and pessimistic priors, respectively). There was a very low probability that the effect size was equal or larger than a consensus-defined minimal clinically important difference. Patients allocated to the accelerated strategy had a lower number of KRT-free days (median absolute difference of - 3.55 days [95% CrI - 6.38; - 0.48]), with a probability that the accelerated strategy was associated with more KRT-free days of 0.008. Hospital-free days were similar between strategies, with the accelerated strategy having a median absolute difference of 0.48 more hospital-free days (95% ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/wos/WOS:000844751300001; volume:26; issue:1; firstpage:255; journal:CRITICAL CARE; http://hdl.handle.net/20.500.11768/131671Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85136589389 |
| DOI: | 10.1186/s13054-022-04120-y |
| الإتاحة: | https://doi.org/20.500.11768/131671Test https://doi.org/10.1186/s13054-022-04120-yTest https://hdl.handle.net/20.500.11768/131671Test |
| رقم الانضمام: | edsbas.F87DDB67 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s13054-022-04120-y |
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