Supraphysiological 25-hydroxy vitamin D3 level at admission is associated with illness severity and mortality in critically ill patients
| Autor: | Bala Venkatesh, Anugrah Chrispal, Ravikar Ralph, John Victor Peter, Kurien Thomas, Joseph Dian, Anand Zachariah, Tunny Sebastian |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Vitamin medicine.medical_specialty Critical Illness Endocrinology Diabetes and Metabolism Severity of Illness Index vitamin D deficiency chemistry.chemical_compound Endocrinology Internal medicine Severity of illness Vitamin D and neurology medicine Humans Orthopedics and Sports Medicine Hospital Mortality Prospective Studies Simplified Acute Physiology Score Prospective cohort study Cholecalciferol business.industry General Medicine Odds ratio Middle Aged Vitamin D Deficiency medicine.disease Surgery Intensive Care Units chemistry SAPS II Female business |
| Zdroj: | Journal of Bone and Mineral Metabolism. 33:239-243 |
| ISSN: | 1435-5604 0914-8779 |
| DOI: | 10.1007/s00774-014-0585-7 |
| Popis: | We studied the association between admission serum 25-hydroxy vitamin D3 level and in-hospital mortality in a prospective cohort of critically ill patients admitted to the medical intensive care unit of a tertiary care referral center. Of the 180 patients enrolled, 129 were included. Vitamin D3 deficiency was observed in 37 % (n = 48) and supra-physiological levels (≥250 nmol/L) in 15.5 % (n = 20). Patients with supraphysiological vitamin D3 levels were grouped as outliers. There was no difference in mortality (p = 0.41) between vitamin D3 deficient (21/48) and non-deficient (36/81) patients in analysis with and without outliers. Patients with vitamin D3 ≥250 nmol/L had a significantly higher (p = 0.02) Simplified Acute Physiology Score (SAPS) II and mortality (p = 0.003) [mean (SD) 60.1 ± 17.1 and 75 % (15/20), respectively] when compared with the rest [45.6 ± 18 and 38.5 % (42/109), respectively]. The sensitivity, specificity and SAPS II independent odds ratio to predict mortality in patients with supraphysiological vitamin D3 levels were 26.3, 93.1 and 3.7 % (95 % confidence interval 1.2–11.4; p = 0.03), respectively. In conclusion, vitamin D3 deficiency in our cohort was not associated with mortality. A patient subset with supra-physiological vitamin D levels had higher illness severity scores and mortality. Extrinsic factors interfering with test results were ruled out. A biological hypothesis to explain this observation is proposed. Further clarification of mechanisms leading to this observation is warranted. |
| Databáze: | OpenAIRE |
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