High-Dose Zinc Supplementation Therapy Does Not Improve Survival Rates in Severe Trauma Patients: A Single-Center Retrospective Observational Study.

The study population was classified into three zinc supplementation dose groups with differing baseline nutritional characteristics.

• Of 196 total patients, 86 were in the low-dose group (<15 mg/day), 16 in the medium-dose group (15–50 mg/day), and 94 in the high-dose group (>50 mg/day).
• All patients had severe trauma defined by Injury Severity Score (ISS) >15 and required mechanical ventilation.
• Patients were admitted to a single emergency ICU between April 2015 and March 2023.
• The high-dose group had significantly poorer nutritional status and lower serum zinc levels compared to the other groups.

No significant differences in severity scores were observed across the three zinc supplementation dose groups.

• Injury Severity Score (ISS) did not differ significantly between the low-, medium-, and high-dose groups.
• This suggests that differences in clinical outcomes cannot be attributed to baseline injury severity differences between groups.

High-dose zinc supplementation showed no significant association with improved 30-day survival in adjusted analyses.

• The primary outcome was 30-day survival rate.
• Multivariable regression was used to evaluate the association between high-dose zinc supplementation and clinical outcomes after adjusting for confounding factors.
• No significant differences in 30-day survival rates were observed across the low-, medium-, and high-dose groups.
• The adjusted analyses confirmed the lack of benefit of high-dose supplementation over standard doses.

High-dose zinc supplementation did not improve any secondary clinical outcomes compared with standard doses.

• Secondary outcomes included 90-day survival rate, length of ICU stay, and hospital-acquired pneumonia.
• No significant differences were observed between groups for any of the secondary outcomes.
• This indicates a consistent lack of benefit across multiple clinical endpoints.

Hypozincemia associated with severe trauma is recognized as contributing to immune dysfunction and poor prognosis, but optimal zinc supplementation dosage remains unclear.

• The clinical utility and optimal dosage of zinc supplementation in severe trauma patients were described as unclear prior to this study.
• It was specifically unclear whether high-dose administration exceeding standard recommendations improves prognosis.
• The study was designed to address whether doses exceeding 50 mg/day provided additional benefit in mechanically ventilated severe trauma patients.

The authors concluded that high-dose zinc supplementation should not be routinely used for severe trauma based on these findings.

• The study was a single-center retrospective observational design, which limits causal inference.
• The authors stated: 'These results do not support the use of high-dose zinc supplementation for severe trauma.'
• The conclusion applied specifically to patients with ISS >15 requiring mechanical ventilation.