Low vitamin D at ICU admission is associated with cancer, infections, acute respiratory insufficiency, and liver failure

Autor: João Felipe Mota, Tatyanne Ln Gomes, Liana Lima Vieira, Gustavo D. Pimentel, Marciano de Sousa Nobrega, Claude Pichard, Renata C. Fernandes, Raquel Machado Schincaglia
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Time Factors
Organ Dysfunction Scores
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Comorbidity
Severity of Illness Index
Gastroenterology
law.invention
Liver disease
Patient Admission
0302 clinical medicine
law
Neoplasms
Hospital Mortality
Vitamin D
APACHE
ddc:616
Nutrition and Dietetics
APACHE II
Clinical outcome
Middle Aged
Prognosis
Intensive care unit
Intensive Care Units
C-Reactive Protein
Acute Disease
Female
SOFA score
Respiratory Insufficiency
Adult
medicine.medical_specialty
Critical Illness
030209 endocrinology & metabolism
Infections
vitamin D deficiency
03 medical and health sciences
Internal medicine
medicine
Vitamin D and neurology
Humans
Aged
Mechanical ventilation
030109 nutrition & dietetics
business.industry
Odds ratio
Vitamin D Deficiency
medicine.disease
Respiration
Artificial
Cross-Sectional Studies
business
Liver Failure
Zdroj: Nutrition, Vol. 60 (2019) pp. 235-240
ISSN: 0899-9007
DOI: 10.1016/j.nut.2018.10.018
Popis: Objectives Vitamin D deficiency may be associated with comorbidities and poor prognosis. However, this association in patients in the intensive care unit (ICU) has not been fully elucidated. The aim of this study was to investigate whether the serum concentrations of 25-hydroxyvitamin D (25[OH]D) within the first 48 h after ICU admission are associated with prognostic indicators (Acute Physiology and Chronic Health Evaluation [APACHE] II, Sequential Organ Failure Assessment [SOFA] score, Charlson comorbidity index [CCI]), clinical complications, serum C-reactive protein (CRP) concentrations, mechanical ventilation duration, and mortality. Methods Seventy-one patients were admitted to the ICU, and their concentrations of 25(OH)D in the first 48 h were analyzed. To evaluate the prognostic factors in the ICU, APACHE II scores, SOFA scores, CCI questionnaires, mechanical ventilation time, CRP, and mortality were used. Results The mean concentration of 25(OH)D was 17.7 ± 8.27 ng/mL (range 3.5–37.5 ng/mL), with 91.6% presenting with deficiency at admission. Although no associations were found between serum 25(OH)D concentrations with mechanical ventilation time, CRP, mortality, and APACHE II and SOFA severity scores, we found associations with the CCI when adjusted by age (model 1: odds ratio [OR], 1.64; 95% confidence interval [CI], 1.14–2.34) and by age, sex and body mass index (model 2: OR, 1.59; 95% CI, 1.10–2.34). In addition, among the comorbidities present, 25(OH)D concentrations were inversely associated with cancer (crude model OR, 3.42; 95% CI, 1.21–9.64) and liver disease (crude model OR, 9.64; 95% CI, 2.28–40.60). Conclusion We found a strong association between 25(OH)D concentrations and the prognostic indicator CCI and clinical complications (acute respiratory insufficiency, acute liver failure, and infections), but no associations with the prognostic indicators APACHE II and SOFA score, CRP, mechanical ventilation duration, or mortality. The main comorbidities associated with low 25(OH)D were cancer and liver disease, suggesting that the determination of 25(OH)vitamin D is relevant during the ICU stay.
Databáze: OpenAIRE
Externí odkaz: