Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study
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 un...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | Critical Care |
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| Online Access: | https://doi.org/10.1186/s13054-019-2693-1 |
| _version_ | 1819059925928640512 |
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| author | Mikio Nakajima Morita Kojiro Shotaro Aso Hiroki Matsui Kiyohide Fushimi Yasuhiko Kaita Hideaki Goto Yoshihiro Yamaguchi Hideo Yasunaga |
| author_facet | Mikio Nakajima Morita Kojiro Shotaro Aso Hiroki Matsui Kiyohide Fushimi Yasuhiko Kaita Hideaki Goto Yoshihiro Yamaguchi Hideo Yasunaga |
| author_sort | Mikio Nakajima |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T14:18:51Z |
| format | Article |
| id | doaj.art-339d3c34134046ebb0134166cb24c6be |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-12-21T14:18:51Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-339d3c34134046ebb0134166cb24c6be2022-12-21T19:00:50ZengBMCCritical Care1364-85352019-12-012311810.1186/s13054-019-2693-1Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort studyMikio Nakajima0Morita Kojiro1Shotaro Aso2Hiroki Matsui3Kiyohide Fushimi4Yasuhiko Kaita5Hideaki Goto6Yoshihiro Yamaguchi7Hideo Yasunaga8Emergency and Critical Care Center, Tokyo Metropolitan Hiroo HospitalDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoDepartment of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of MedicineDepartment of Trauma and Critical Care Medicine, Kyorin University School of MedicineEmergency and Critical Care Center, Tokyo Metropolitan Hiroo HospitalDepartment of Trauma and Critical Care Medicine, Kyorin University School of MedicineDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoAbstract 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.https://doi.org/10.1186/s13054-019-2693-1BurnVitamin CAscorbic acidPropensity scoreMatchingCompeting risk |
| spellingShingle | Mikio Nakajima Morita Kojiro Shotaro Aso Hiroki Matsui Kiyohide Fushimi Yasuhiko Kaita Hideaki Goto Yoshihiro Yamaguchi Hideo Yasunaga Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study Critical Care Burn Vitamin C Ascorbic acid Propensity score Matching Competing risk |
| title | Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study |
| title_full | Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study |
| title_fullStr | Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study |
| title_full_unstemmed | Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study |
| title_short | Effect of high-dose vitamin C therapy on severe burn patients: a nationwide cohort study |
| title_sort | effect of high dose vitamin c therapy on severe burn patients a nationwide cohort study |
| topic | Burn Vitamin C Ascorbic acid Propensity score Matching Competing risk |
| url | https://doi.org/10.1186/s13054-019-2693-1 |
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