| アブストラクト | 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. |
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| ジャーナル名 | Critical care (London, England) |
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| 投稿日 | 2019/12/14 |
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| 投稿者 | Nakajima, Mikio; Kojiro, Morita; Aso, Shotaro; Matsui, Hiroki; Fushimi, Kiyohide; Kaita, Yasuhiko; Goto, Hideaki; Yamaguchi, Yoshihiro; Yasunaga, Hideo |
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| 組織名 | Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, 2-34-10,;Ebisu, Shibuya-ku, Tokyo, 150-0013, Japan. mikioh@ks.kyorin-u.ac.jp.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan. mikioh@ks.kyorin-u.ac.jp.;Department of Trauma and Critical Care Medicine, Kyorin University School of;Medicine, Tokyo, Japan. mikioh@ks.kyorin-u.ac.jp.;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan.;Medicine, Tokyo, Japan.;Ebisu, Shibuya-ku, Tokyo, 150-0013, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31831039/ |
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