BackgroundVitamin 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.MethodsWe 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.ResultsEligible 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).ConclusionsHigh-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.

中文翻译：

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大剂量维生素 C 治疗对严重烧伤患者的影响：一项全国性队列研究

背景维生素 C 是一种有据可查的抗氧化剂，可减少高剂量的氧化应激和输液；然而，高剂量维生素 C 与死亡率降低之间的关联仍不清楚。本研究在两个不同阈值下评估大剂量维生素 C 对重度烧伤患者的影响。 方法我们招募了 2010 年至 2016 年在日本诊断程序组合国家住院患者数据库中注册的重度烧伤（烧伤指数≥15）成年患者。在入院 1 天内接受高剂量维生素 C 的患者（维生素 C 组）和未接受高剂量维生素 C 的患者（对照组）之间进行倾向评分匹配。高剂量维生素 C 定义为入院 2 天内剂量超过 10 g 或 24 g。主要结局是院内死亡率。结果符合条件的患者 (n = 2713) 被分为维生素 C 组 (n = 157) 或对照组 (n = 2556)。在 1:4 倾向评分匹配后，我们分别比较了 157 和 628 名接受高剂量维生素 C（> 10 克阈值）和对照组的患者。在此特定阈值下，高剂量维生素 C 治疗与院内死亡率降低相关（风险比，0.79；95% 置信区间，0.66–0.95；p = 0.006）。相比之下，在 > 24 g 阈值下，对照组和高剂量维生素 C 组的住院死亡率没有差异（风险比，0.83；95% 置信区间，0.68–1.02；p = 0.068）。结论高剂量如果在入院前 2 天内使用维生素 C 的最低阈值低于 10 克，则严重烧伤患者的维生素 C 治疗可降低死亡率。