Vitamin D status and the risk for hospital-acquired infections in critically ill adults: a prospective cohort study.

Autor: Kempker JA; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine, 615 Michael Street, Suite 205, Atlanta, GA 30322, United States of America., West KG; Emory University School of Medicine, Atlanta, United States of America., Kempker RR; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, United States of America., Siwamogsatham O; Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, United States of America., Alvarez JA; Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, United States of America., Tangpricha V; Division of Endocrinology, Metabolism and Lipids, Atlanta VA Medical Center & Emory University School of Medicine, Atlanta, United States of America., Ziegler TR; Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, United States of America., Martin GS; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine, 615 Michael Street, Suite 205, Atlanta, GA 30322, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2015 Apr 07; Vol. 10 (4), pp. e0122136. Date of Electronic Publication: 2015 Apr 07 (Print Publication: 2015).
DOI: 10.1371/journal.pone.0122136
Abstrakt: Introduction: To identify patient characteristics associated with low serum 25-hydroxyvitamin D (25(OH)D) concentrations in the medical intensive care unit (ICU) and examine the relationship between serum 25(OH)D and the risk for hospital-acquired infections.
Methods: This is a prospective observational cohort of adult patients admitted to the medical ICU at an urban safety net teaching hospital in Atlanta, Georgia from November 1, 2011 through October 31, 2012 with an anticipated ICU stay ≥ 1 day. Phlebotomy for serum 25(OH)D measurement was performed on all patients within 5 days of ICU admission. Patients were followed for 30 days or until death or hospital discharge, whichever came first. Hospital-acquired infections were determined using standardized criteria from review of electronic medical record.
Results: Among the 314 patients analyzed, 178 (57%) had a low vitamin D at a serum 25(OH)D concentration < 15 ng/mL. The patient characteristics associated with low vitamin D included admission during winter months (28% vs. 18%, P = 0.04), higher PaO2/FiO2 (275 vs. 226 torr, P = 0.03) and a longer time from ICU admission to study phlebotomy (1.8 vs. 1.5 days, P = 0.02). A total of 36 (11%) patients were adjudicated as having a hospital-acquired infection and in multivariable analysis adjusting for gender, alcohol use, APACHE II score, time to study phlebotomy, ICU length of stay and net fluid balance, serum 25(OH)D levels < 15 ng/mL were not associated with risk for hospital-acquired infections (HR 0.85, 95% CI 0.40-1.80, P = 0.7).
Conclusions: In this prospective, observational cohort of adults admitted to a single-center medical ICU, we did not find a significant association between low 25(OH)D and the risk for hospital-acquired infections.
Databáze: MEDLINE
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