Vitamin D deficiency is independently associated with mortality among critically ill patients

Clinics (Sao Paulo). 2015 May;70(5):326-32. doi: 10.6061/clinics/2015(05)04. Epub 2015 May 1.

Abstract

Objective: Studies suggest an association between vitamin D deficiency and morbidity/mortality in critically ill patients. Several issues remain unexplained, including which vitamin D levels are related to morbidity and mortality and the relevance of vitamin D kinetics to clinical outcomes. We conducted this study to address the association of baseline vitamin D levels and vitamin D kinetics with morbidity and mortality in critically ill patients.

Method: In 135 intensive care unit (ICU) patients, vitamin D was prospectively measured on admission and weekly until discharge from the ICU. The following outcomes of interest were analyzed: 28-day mortality, mechanical ventilation, length of stay, infection rate, and culture positivity.

Results: Mortality rates were higher among patients with vitamin D levels <12 ng/mL (versus vitamin D levels >12 ng/mL) (32.2% vs. 13.2%), with an adjusted relative risk of 2.2 (95% CI 1.07-4.54; p< 0.05). There were no differences in the length of stay, ventilation requirements, infection rate, or culture positivity.

Conclusions: This study suggests that low vitamin D levels on ICU admission are an independent risk factor for mortality in critically ill patients. Low vitamin D levels at ICU admission may have a causal relationship with mortality and may serve as an indicator for vitamin D replacement among critically ill patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Brazil / epidemiology
  • Critical Illness
  • Dialysis
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay
  • Male
  • Middle Aged
  • Organ Dysfunction Scores
  • Parathyroid Hormone / blood
  • Patient Admission
  • Patient Discharge
  • Prospective Studies
  • Respiration, Artificial
  • Risk
  • Sensitivity and Specificity
  • Vitamin D / blood*
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / mortality*

Substances

  • Parathyroid Hormone
  • Vitamin D