|
|
|
|
|
| Association between Vitamin D deficiency and mortality in critically ill patients |
| ZHANG Song-da，GENG Zang-jiancuo，LI Wei-hong |
| The Department of Pharmacy，Fourth People’s Hospital of Qinghai，Xining 810000，China |
|
|
|
|
Abstract Objective To evaluate the association between vitamin D deficiency and morbidity/mortality in ICU patients. Methods In 289 intensive care unit（ICU）patients，vitamin D was prospectively measured on admission and weekly until discharge from the ICU. The following outcomes were analyzed: 30-day mortality，mechanical ventilation，length of stay，infection rate，and culture positivity.Results ROC curve showed the best diagnostic cutoff value of 25（OH）D level was 12 ng/mL. Mortality in Vitamin D deficiency group [25（OH）D≤12 ng/mL] was higher than that in non-vitamin D deficiency group [25（OH）D＞12 ng/mL]，with an adjusted relative risk of 2.21（95% CI 1.08~4.55，P＝0.032）.There were no differences in the length of ICU stay，ventilation requirements，infection rate，and culture positivity. Conclusion This study suggests that low vitamin D level on ICU admission is an independent risk factor for mortality in critically ill patients.
|
|
Received: 19 January 2016
|
| About author:: ZHANG Song-da，E-mail:zhangsongdqh@sina.com |
|
|
|
| [1] Tagliabue E，Raimondi S，Gandini S. Vitamin D，Cancer Risk，and Mortality[J]. Adv Food Nutr Res，2015，
75:1-52.
[2] Braun A，Chang D，Mahadevappa K，et al. Association of low serum 25-hydroxyvitamin D levels and mortality
in the critically ill[J]. Crit Care Med，2011，39（4）: 671-677.
[3] McKinney JD，Bailey BA，Garrett LH，et al.Relationship between vitamin D status and ICU outcomes in
veterans[J]. J Am Med Dir Assoc，2011，12（3）: 208-211.
[4] Matthews LR，Ahmed Y，Wilson KL，et al. Worsening severity of vitamin D deficiency is associated with
increased length of stay，surgical intensive care unit cost，and mortality rate in surgical intensive care
unit patients[J]. Am J Surg，2012，204（1）: 37-43.
[5] Higgins DM，Wischmeyer PE，Queensland KM，et al. Relationship of vitamin D deficiency to clinical
outcomes in critically ill patients[J]. JPEN J Parenter Enteral Nutr，2012，36（6）:713-720.
[6] Dusso AS，Brown AJ，Slatopolsky E. Vitamin D[J]. Am J Physiol Renal Physiol，2005，289（1）: F8-28.
[7] Cheng JB，Levine MA，Bell NH，et al. Genetic evidence that the human CYP2R1 enzyme is a key vitamin
D 25- hydroxylase[J].Proc Natl Acad Sci USA，2004，101（20）:7711-7715.
[8] Hewison M，Zehnder D，Chakraverty R，et al. Vitamin D and barrier function: a novel role for extra-renal
1 alpha-hydroxylase[J]. Mol Cell Endocrinol，2004，215（1-2）:31-38.
[9] Lucidarme O，Messai E，Mazzoni T，etal. Incidence and risk factors of vitamin D deficiency in critically
ill patients: results from a prospective observational study[J]. Intensive Care Med，2010，36（9）: 1609-1611.
[10] Nair P，Lee P，Reynolds C，et al. Significant perturbation of vitamin D-parathyroid-calcium axis and
adverse clinical outcomes in critically ill patients[J]. Intensive Care Med, 2013，39（2）:267-274.
[11] Venkatram S，Chilimuri S，Adrish M，et al. Vitamin D deficiency is associated with mortality in the
medical intensive care unit[J].Crit Care，2011，15（6）: R292.
[12] Lee P，Nair P，Eisman JA，et al. Vitamin D deficiency in the intensive care unit: an invisible
accomplice to morbidity and mortality[J]. Intensive Care Med，2009，35（12）:2028-2032.
[13] Cecchi A，Bonizzoli M，Douar S，et al. Vitamin D deficiency in septic patients at ICU admission is not a
mortality predictor[J]. Minerva Anestesiol，2011，77（12）: 1184-1189.
[14] 钱璟，丁峰. 维生素 D 缺乏与危重病患者死亡率的关系研究现状[J]. 中国血液净化，2013，12（2）:94-97.
[15] Scalco R，Premaor MO，Froehlich PE，et al. High prevalence of hypovitaminosis D and secondary
hyperparathyroidism in elders living in nonprofit homes in South Brazil[J]. Endocrine，2008，33（1）: 95-100.
[16] Nair P，Lee P，Reynolds C，et al. Significant perturbation of vitamin D-parathyroid-calcium axis and
adverse clinical outcomes in critically ill patients[J]. Intensive Care Med，2013，39（2）: 267-274. |
|
|
|
Address: 1 North 2nd Street,
Zhongguancun, 
