Vitamin C For Burn Patients

Vitamin C For Burn Patients

Comment

doi: 10.1186/s13054-019-2693-1.

Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study

Affiliations

• PMID: 31831039
• PMCID: PMC6909452
• DOI: 10.1186/s13054-019-2693-1

Free PMC article

Comment

Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study

Mikio Nakajima  et al. Crit Care. 2019 .

Free PMC article

Abstract

Background: Vitamin C is a well-documented antioxidant that reduces oxidative stress and fluid infusion in high doses; however, the association between high-dose vitamin C and reduced mortality remains unclear. This study evaluates the effect of high-dose vitamin C in severe burn patients under two varying thresholds.

Methods: We enrolled adult patients with severe burns (burn index ≥ 15) who were registered in the Japanese Diagnosis Procedure Combination national inpatient database from 2010 to 2016. Propensity score matching was performed between patients who received high-dose vitamin C within 1 day of admission (vitamin C group) and those who did not (control group). High-dose vitamin C was defined as a dosage in excess of 10 g or 24 g within 2 days of admission. The primary outcome was in-hospital mortality.

Results: Eligible patients (n = 2713) were categorized into the vitamin C group (n = 157) or control group (n = 2556). After 1:4 propensity score matching, we compared 157 and 628 patients who were administered high-dose vitamin C (> 10-g threshold) and controls, respectively. Under this particular threshold, high-dose vitamin C therapy was associated with reduced in-hospital mortality (risk ratio, 0.79; 95% confidence interval, 0.66-0.95; p = 0.006). In contrast, in-hospital mortality did not differ between the control and high-dose vitamin C group under the > 24-g threshold (risk ratio, 0.83; 95% confidence interval, 0.68-1.02; p = 0.068).

Conclusions: High-dose vitamin C therapy was associated with reduced mortality in patients with severe burns when used under a minimum threshold of 10 g within the first 2 days of admission. While "high-dose" vitamin C therapy lacks a universal definition, the present study reveals that different "high-dose" regimens may yield improved outcomes.

Keywords: Ascorbic acid; Burn; Competing risk; Matching; Propensity score; Vitamin C.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

Patient selection (10 g minimum threshold of high-dose vitamin C)

Fig. 2

Primary outcomes under varying high-dose vitamin C thresholds after propensity score matching, ^†10-g minimum threshold within 2 days of admission, ^††24-g minimum threshold within 2 days of admission

Fig. 3

Secondary outcomes after propensity-score matching under varying high-dose vitamin C thresholds, ^†10-g minimum threshold within 2 days of admission, ^††24-g minimum threshold within 2 days of admission

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  Ren J, Jin X, Gao Y, Li R, Li J, Zhang J, Wang X, Wang G. Ren J, et al. Crit Care. 2020 Jan 7;24(1):8. doi: 10.1186/s13054-020-2725-x. Crit Care. 2020. PMID: 31910873 Free PMC article. No abstract available.

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  Aguilar G, Ferriols R, Martínez-Castro S, Ezquer C, Pastor E, Carbonell JA, Alós M, Navarro D. Aguilar G, et al. Crit Care. 2019 Apr 26;23(1):145. doi: 10.1186/s13054-019-2434-5. Crit Care. 2019. PMID: 31027499 Free PMC article. No abstract available.

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Vitamin C For Burn Patients

Source: https://pubmed.ncbi.nlm.nih.gov/31831039/