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Early Vitamin C and Thiamine Administration to Patients with Septic Shock in Emergency Departments: Propensity Score-Based Analysis of a Before-and-After Cohort Studyopen access

Authors
Shin, Tae GunKim, Youn-JungRyoo, Seung MokHwang, Sung YeonJo, Ik JoonChung, Sung PhilChoi, Sung-HyukSuh, Gil JoonKim, Won Young
Issue Date
Jan-2019
Publisher
MDPI AG
Keywords
sepsis; septic shock; thiamine; vitamin C; resuscitation
Citation
Journal of Clinical Medicine, v.8, no.1
Indexed
SCIE
SCOPUS
Journal Title
Journal of Clinical Medicine
Volume
8
Number
1
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/2552
DOI
10.3390/jcm8010102
ISSN
2077-0383
Abstract
Background: Intravenous vitamin C and thiamine administration may be a potential adjuvant therapy for septic shock. We aimed to investigate the impact of early vitamin C and thiamine administration in septic shock patients. Methods: This retrospective before-and-after cohort study used data extracted from the Korean Shock Society's prospective septic shock registry. We compared 28-day and in-hospital mortality rates between patients treated with intravenous vitamin C (3 g/12 h or 1.5 g/6 h) and thiamine (200 mg/12 h) <6 h after shock recognition from July through December 2017 (n = 229) and control patients from October 2015 through June 2017 (n = 915) using propensity score matching. Results: The 28-day (18.3% vs. 17.5%; p = 0.76) and in-hospital (16.6% vs. 18.3%; p = 0.55) mortality rates did not differ between treatment and control groups, nor did 28-day (18.5% vs. 17.5%; p = 0.84) and in-hospital (16.7% vs. 18.4%; p = 0.54) mortality rates after matching. In the subgroup analysis, treatment was associated with lower in-hospital mortality rates in patients with albumin <3.0 mg/dL or a Sequential Organ Failure Assessment (SOFA) score >10. Conclusion: Early vitamin C and thiamine administration in patients with septic shock did not improve survival; however, administration could benefit conditions that are more severe, such as hypoalbuminemia or severe organ failure.
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Choi, Sung Hyuk
Guro Hospital (Department of Emergency Medicine, Guro Hospital)
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