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Intern Med J. 2019 Feb;49(2):189-196. doi: 10.1111/imj.14030.

Vitamin C deficiency in Australian hospitalised patients: an observational study.

Author information

1
Department of General Medicine, Flinders Medical Centre, Flinders Drive, South Australia, Australia.
2
College of Medicine and Public Health, Flinders University, Flinders Drive, South Australia, Australia.
3
Department of Nutrition and Dietetics, Flinders University, South Australia, Australia.
4
Department of Clinical Epidemiology, Flinders Medical Centre, South Australia, Australia.
5
Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia.

Abstract

BACKGROUND:

Vitamin C has anti-oxidant properties and acts as a cofactor for several enzymes. Hypovitaminosis C has been associated with bleeding, endothelial dysfunction and death. The prevalence of hypovitaminosis C is unknown in Australian hospitalised patients, and its clinical relevance is uncertain.

AIMS:

To determine the prevalence, characteristics and clinical outcomes of hospitalised patients with hypovitaminosis C.

METHODS:

This observational study included general-medical inpatients in a tertiary-level hospital in Australia. High-performance liquid chromatography (HPLC) was used to determine plasma vitamin C levels. As per Johnston's criteria, vitamin C levels of ≥28 μmol/L were classified as normal and <28 μmol/L as low. Clinical outcomes determined included length of hospital stay (LOS), nosocomial complications, intensive care unit admission and in-hospital mortality.

RESULTS:

A total of 200 patients participated in this study, and vitamin C levels were available for 149 patients, of whom 35 (23.5%) had normal vitamin C levels, and 114 (76.5%) had hypovitaminosis C. Patients with hypovitaminosis C were older and had higher C-reactive protein (CRP) levels. Median LOS was 2 days longer in patients with hypovitaminosis C (6 days (interquartile range (IQR) 4, 8) vs 4 days (IQR 3, 6), P = 0.02), and they had fourfold higher odds of staying in hospital for >5 days than those with normal vitamin C levels. Other clinical outcomes were similar between the two groups.

CONCLUSIONS:

Hypovitaminosis C is common in hospitalised patients and is associated with prolonged LOS. Further research is needed to ascertain the benefits of vitamin C supplementation in vitamin C-depleted patients.

KEYWORDS:

clinical outcomes; hospitalised patients; prevalence; vitamin C

PMID:
29968401
DOI:
10.1111/imj.14030
[Indexed for MEDLINE]

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