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Comment & Response
March 12, 2014

Mortality in Patients With Hypovolemic Shock Treated With Colloids or Crystalloids

Author Affiliations
  • 1Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
  • 2George Institute for Global Health, University of Sydney, Sydney, Australia
JAMA. 2014;311(10):1067-1068. doi:10.1001/jama.2014.833

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.

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