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呋塞米与安慰剂治疗重症监护患者液体超负荷的随机 GODIF 试验第二版:统计分析计划。

Furosemide versus placebo for fluid overload in intensive care patients-The randomised GODIF trial second version: Statistical analysis plan.

机构信息

Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark.

Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

Acta Anaesthesiol Scand. 2024 Jan;68(1):130-136. doi: 10.1111/aas.14320. Epub 2023 Sep 11.

Abstract

BACKGROUND

Fluid overload is associated with increased mortality in intensive care unit (ICU) patients. The GODIF trial aims to assess the benefits and harms of fluid removal with furosemide versus placebo in stable adult patients with moderate to severe fluid overload in the ICU. This article describes the detailed statistical analysis plan for the primary results of the second version of the GODIF trial.

METHODS

The GODIF trial is an international, multi-centre, randomised, stratified, blinded, parallel-group, pragmatic clinical trial, allocating 1000 adult ICU patients with moderate to severe fluid overload 1:1 to furosemide versus placebo. The primary outcome is days alive and out of hospital within 90 days post-randomisation. With a power of 90% and an alpha level of 5%, we may reject or detect an improvement of 8%. The primary analyses of all outcomes will be performed in the intention-to-treat population. For the primary outcome, the Kryger Jensen and Lange method will be used to compare the two treatment groups adjusted for stratification variables supplemented with sensitivity analyses in the per-protocol population and with further adjustments for prognostic variables. Secondary outcomes will be analysed with multiple linear regressions, logistic regressions or the Kryger Jensen and Lange method as suitable with adjustment for stratification variables.

CONCLUSION

The GODIF trial data will increase the certainty about the effects of fluid removal using furosemide in adult ICU patients with fluid overload.

TRIAL REGISTRATIONS

EudraCT identifier: 2019-004292-40 and ClinicalTrials.org: NCT04180397.

摘要

背景

液体超负荷与重症监护病房(ICU)患者的死亡率增加有关。GODIF 试验旨在评估在 ICU 中有中度至重度液体超负荷的稳定成年患者中,使用呋塞米与安慰剂相比,进行液体清除的益处和危害。本文描述了 GODIF 试验第二版主要结果的详细统计分析计划。

方法

GODIF 试验是一项国际性、多中心、随机、分层、盲法、平行组、实用临床研究,将 1000 名 ICU 中有中度至重度液体超负荷的成年患者以 1:1 的比例随机分配至呋塞米组和安慰剂组。主要结局是随机分组后 90 天内存活并出院的天数。在 90%的功效和 5%的α水平下,我们可能会拒绝或检测到 8%的改善。所有结局的主要分析都将在意向治疗人群中进行。对于主要结局,将使用 Kryger Jensen 和 Lange方法比较两组治疗,调整分层变量,并在方案人群中进行敏感性分析,并进一步调整预后变量。次要结局将使用多元线性回归、逻辑回归或 Kryger Jensen 和 Lange方法进行分析,适合调整分层变量。

结论

GODIF 试验数据将增加对使用呋塞米清除成人 ICU 液体超负荷患者液体的效果的确定性。

试验注册

EudraCT 标识符:2019-004292-40 和 ClinicalTrials.org:NCT04180397。

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