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SHR Neuro Cancer Cardio Lipid Metab Microb
Amrein, K; Zajic, P; Schnedl, C; Waltensdorfer, A; Fruhwald, S; Holl, A; Purkart, T; Wünsch, G; Valentin, T; Grisold, A; Stojakovic, T; Amrein, S; Pieber, TR; Dobnig, H.
Vitamin D status and its association with season, hospital and sepsis mortality in critical illness.
Crit Care. 2014; 18(2):R47-R47
Doi: 10.1186/cc13790
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- Leading authors Med Uni Graz
- Amrein Karin
- Zajic Paul
- Co-authors Med Uni Graz
- Amrein Steven
- Dobnig Harald
- Fruhwald Sonja
- Grisold Andrea
- Holl Alexander
- Pieber Thomas
- Schnedl Christian
- Stojakovic Tatjana
- Urbanic Purkart Tadeja
- Valentin Thomas
- Waltensdorfer Andreas
- Wünsch Gerit
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- Abstract:
- Vitamin D plays a key role in immune function. Deficiency may aggravate the incidence and outcome of infectious complications in critically ill patients. We aimed to evaluate the prevalence of vitamin D deficiency and the correlation between serum 25-hydroxyvitamin D (25(OH) D) and hospital mortality, sepsis mortality and blood culture positivity. In a single-center retrospective observational study at a tertiary care center in Graz, Austria, 655 surgical and nonsurgical critically ill patients with available 25(OH) D levels hospitalized between September 2008 and May 2010 were included. Cox regression analysis adjusted for age, gender, severity of illness, renal function and inflammatory status was performed. Vitamin D levels were categorized by month-specific tertiles (high, intermediate, low) to reflect seasonal variation of serum 25(OH) D levels. Overall, the majority of patients were vitamin D deficient (<20 ng/ml; 60.2%) or insufficient (≥20 and <30 ng/dl; 26.3%), with normal 25(OH) D levels (>30 ng/ml) present in only 13.6%. The prevalence of vitamin D deficiency and mean 25(OH) D levels was significantly different in winter compared to summer months (P <0.001). Hospital mortality was 20.6% (135 of 655 patients). Adjusted hospital mortality was significantly higher in patients in the low (hazard ratio (HR) 2.05, 95% confidence interval (CI) 1.31 to 3.22) and intermediate (HR 1.92, 95% CI 1.21 to 3.06) compared to the high tertile. Sepsis was identified as cause of death in 20 of 135 deceased patients (14.8%). There was no significant association between 25(OH) D and C-reactive protein (CRP), leukocyte count or procalcitonin levels. In a subgroup analysis (n = 244), blood culture positivity rates did not differ between tertiles (23.1% versus 28.2% versus 17.1%, P = 0.361). Low 25(OH) D status is significantly associated with mortality in the critically ill. Intervention studies are needed to investigate the effect of vitamin D substitution on mortality and sepsis rates in this population.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Biomarkers - blood
- Critical Illness - mortality
- Female -
- Hospital Mortality - trends
- Humans -
- Male -
- Middle Aged -
- Retrospective Studies -
- Seasons -
- Sepsis - blood
- Sepsis - diagnosis
- Sepsis - mortality
- Vitamin D - analogs & derivatives
- Vitamin D - blood
- Vitamin D Deficiency - blood
- Vitamin D Deficiency - diagnosis
- Vitamin D Deficiency - mortality