Relationship of Vitamin D Deficiency to Clinical Outcomes in Critically Ill Patients |
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Authors: | David M. Higgins MS Paul E. Wischmeyer MD Kelly M. Queensland BA Stefan H. Sillau MS Alexandra J. Sufit BA Daren K. Heyland MD |
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Affiliation: | 1. Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado;2. Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, Colorado;3. Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada;4. Department of Medicine, Queen's University, Kingston, Ontario, Canada |
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Abstract: | Background: Despite the numerous disease conditions associated with vitamin D deficiency in the general population, the relationship of this deficiency to outcome in critically ill patients remains unclear. The objective of this study is to determine the burden of vitamin D deficiency in intensive care unit (ICU) patients and determine if it is associated with poor patient outcomes. Methods: The authors conducted an analysis of samples collected from a prospective study of 196 patients admitted to a medical/surgical ICU in a tertiary care hospital. They measured serum 25‐hydroxyvitamin D at admission and up to 10 days following admission and followed patients prospectively for 28‐day outcomes. Results: Of analyzable patients, 50 (26%) were deficient (≤30 nmol/L) and 109 (56%) were insufficient (>30 and ≤60 nmol/L). Baseline 25(OH)D levels decreased significantly in all patients after 3 days in the ICU and remained significantly lower through 10 days (P < .001). 25(OH)D status was not significantly associated with 28‐day all‐cause mortality (hazard ratio [HR], 0.89; 95% confidence interval, [CI] 0.37–2.24). Higher levels of 25(OH)D were associated with a shorter time‐to‐alive ICU discharge (HR, 2.11; 95% CI, 1.27–3.51). 25(OH)D‐deficient patients showed a nonstatistically significant trend toward a higher infection rate (odds ratio [OR], 3.20; 95% CI, 0.784–13.07; P = .11) compared with patients with sufficient levels of 25(OH)D. Conclusions: This study demonstrates significant decreases in vitamin D status over the duration of the patient's ICU stay. Low levels of vitamin D are associated with longer time to ICU discharge alive and a trend toward increased risk of ICU‐acquired infection. |
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Keywords: | immunonutrition research and diseases vitamins nutrition critical care research and diseases |
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