Is Treating Patients With Stage 4 Pressure Ulcers With Vitamins A and C, Zinc, and Arginine Justified?

Kunaal Bafna, MS; Tian Chen, PhD; Richard Simman, MD, FACS, FACCWS

Disclosures

Wounds. 2021;33(3):77-80. 

In This Article

Results

The OR of nutrient deficiency as correlated with albumin and prealbumin deficiencies are shown in the Table. The OR of vitamin A deficiency vs albumin deficiency was 0.27 (95% CI, 0.004–3.68), which means the odds of having albumin deficiency (albumin < 3.2 g/dL) for patients with vitamin A deficiency (vitamin A < 0.3 mcg/dL) was 0.27 that for patients without vitamin A deficiency. That is to say, vitamin A deficiency was less likely to be associated with albumin deficiency, but the association was not significant (P = .34). In terms of percentage change, the odds of having albumin deficiency for patients with vitamin A deficiency was 73% lower than the odds for patients without vitamin A deficiency; the deficiency percentages for albumin levels are shown in Figure 1. The OR was 23.0 for vitamin A deficiency vs prealbumin deficiency, suggesting the odds of having prealbumin deficiency in patients with vitamin A deficiency is 23.0 times greater than that in patients without vitamin A deficiency; the deficiency percentages for prealbumin levels are shown in Figure 2.

Figure 1.

Displays the percentage of patients with vitamin deficiency with concurrently acceptable (prealbumin >18 g/dL) or unacceptable (prealbumin <18 g/dL) prealbumin levels. Of note, the number 18 was determined by the authors as a reference point for the prealbumin.
aDenotes strongest correlation.

Figure 2.

Displays the percentage of patients with vitamin deficiency with concurrently acceptable (albumin >3.2 g/dL) or unacceptable (albumin <3.2 g/dL) albumin levels. Of note, the number 3.2 was determined by the authors as a reference point for the albumin.
aDenotes strongest correlation.

With zinc deficiency vs albumin deficiency, the OR was 25.67 (95% CI, 1.2–568.9), which means the odds of having albumin deficiency in patients with zinc deficiency was 25.67 times greater than that for patients without zinc deficiency. That is to say, zinc deficiency was more likely to be associated with albumin deficiency. The association was significant (P = .01). If interpreted in terms of percentage change, the odds of having albumin deficiency for patients with zinc deficiency were 240.67% higher than the odds for patients without zinc deficiency. Although not as high, the odds of having prealbumin deficiency in patients with zinc deficiency were also higher than in patients without zinc deficiency, as the OR was 1.47.

Although not statistically significant, the findings indicated that the odds of having albumin deficiency for patients with arginine deficiency were 1.09 times greater than those for patients without arginine deficiency. Arginine deficiency was more likely to be associated with albumin deficiency. On the other hand, arginine deficiency was less likely to be associated with prealbumin deficiency (OR, 0.76).

Furthermore, the authors found that the odds of having albumin deficiency for patients with vitamin C deficiency were 0.62 times greater than the odds for patients without vitamin C deficiency. As such, vitamin C deficiency was less likely to be associated with albumin deficiency. To the contrary, vitamin C deficiency was more likely to be associated with prealbumin deficiency (OR, 1.47).

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