背景:在高收入国家的急性医院中很少进行维生素C缺乏症(VCD)的评估。然而,随着社区环境对VCD的兴趣日益浓厚,有新的证据调查了住院期间VCD的患病率和影响.
目的:在本范围审查中,探讨了成人住院患者中VCD的患病率,描述了患者特征,并确定与VCD相关的危险因素和临床结局。
方法:根据PRISMA-ScR框架进行系统范围审查。OvidMEDLINE,OvidEmbase,Scopus,CINAHLPlus,联合和补充医学数据库,搜索了Cochrane图书馆的数据库进行干预,比较,和符合资格标准的案例系列研究,包括高收入国家的成人住院患者,根据经济合作与发展组织的定义,使用世界卫生组织参考标准报告VCD患病率。这些标准将VCD缺乏定义为血浆或血清维生素C水平<11.4µmol/L,全血水平<17µmol/L,或白细胞<57nmol/108细胞。
结果:包括23篇文章,代表22项研究。VCD的累积患病率为27.7%(n=2494;95%置信区间[CI],21.3-34.0).在严重急性疾病和营养状况差的患者中观察到VCD的高患病率。在2项研究中(n=71)评估的VCD患者中,有48%至62%存在镰刀。退休(P=0.015)和使用过量的酒精和烟草(P=0.0003)是VCD的独立危险因素(n=184)。年龄与VCD无关(n=631)。两项研究检查了营养关联(n=309);结果不一致。VCD的临床结果包括虚弱风险增加(调整后的比值比,4.3;95CI,1.33-13.86;P=0.015)和认知障碍(调整后的比值比,2.93;95CI,1.05-8.19,P=0.031)(n=160)。
结论:VCD是高收入国家医疗保健系统面临的营养挑战。有必要对VCD患者进行早期识别和治疗的研究。
背景:开放科学框架(https://doi.org/10.17605/OSF.IO/AJGHX)。
BACKGROUND: Assessment for vitamin C deficiency (VCD) is rarely undertaken in an acute hospital setting in high-income countries. However, with growing interest in VCD in community settings, there is emerging evidence investigating the prevalence and impact of VCD during hospitalization.
OBJECTIVE: In this scoping
review, the prevalence of VCD in adult hospitalized patients is explored, patient characteristics are described, and risk factors and clinical outcomes associated with VCD are identified.
METHODS: A systematic scoping
review was conducted in accordance with the PRISMA-ScR framework. The Ovid MEDLINE, Ovid Embase, Scopus, CINAHL Plus, Allied and Complementary Medicine Database, and the Cochrane Library databases were searched for interventional, comparative, and case-series studies that met eligibility criteria, including adult hospital inpatients in high-income countries, as defined by the Organization for Economic Co-operation and Development, that reported VCD prevalence using World Health Organization reference standards. These standards define VCD deficiency as plasma or serum vitamin C level <11.4 µmol/L, wholeblood level <17 µmol/L, or leukocytes <57 nmol/108 cells.
RESULTS: Twenty-three articles were included, representing 22 studies. The cumulative prevalence of VCD was 27.7% (n = 2494; 95% confidence interval [CI], 21.3-34.0). High prevalence of VCD was observed in patients with severe acute illness and poor nutritional status.
Scurvy was present in 48% to 62% of patients with VCD assessed in 2 studies (n = 71). Being retired (P = 0.015) and using excessive amounts of alcohol and tobacco (P = 0.0003) were independent risk factors for VCD (n = 184). Age was not conclusively associated with VCD (n = 631). Two studies examined nutrition associations (n = 309); results were inconsistent. Clinical outcomes for VCD included increased risk of frailty (adjusted odds ratio, 4.3; 95%CI, 1.33-13.86; P = 0.015) and cognitive impairment (adjusted odds ratio, 2.93; 95%CI, 1.05-8.19, P = 0.031) (n = 160).
CONCLUSIONS: VCD is a nutritional challenge facing the healthcare systems of high-income countries. Research focused on early identification and treatment of patients with VCD is warranted.
BACKGROUND: Open Science Framework ( https://doi.org/10.17605/OSF.IO/AJGHX ).