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To the Editor The CRISTAL trial1 requires scrutiny because its results contradict other high-quality evidence.2 The CRISTAL trial was stopped for futility based on no difference in 28-day mortality, but reported numerically lower mortality for the colloids group. However, eFigure 1 in the article suggests lower mortality in the crystalloids group when the trial was stopped. eFigure 2 shows a sudden increase in probability of death at 28 days in both groups; this indicates either censoring (suggesting the denominator for 90-day mortality was wrong) or an unexplained and puzzling cluster of deaths on day 28 resulting in the mortality difference at 90 days.
Bellomo R, Finfer S, Myburgh J. Mortality in Patients With Hypovolemic Shock Treated With Colloids or Crystalloids. JAMA. 2014;311(10):1067-1068. doi:10.1001/jama.2014.833