Burden and Outcome of Vitamin D Deficiency Among Critically Ill Patients: A Prospective Study

• Published in: Nutrition in clinical practice Vol. 32; no. 3; p. 378
• Main Authors: Anwar, Enas, Hamdy, Gehan, Taher, Eman, Fawzy, Esmat, Abdulattif, Sherif, Attia, Mohamed H
• Format: Journal Article
• Language: English
• Published: United States 01.06.2017
• Subjects: Adult; Aged; Critical Illness - mortality; Egypt - epidemiology; Female; Humans; Intensive Care Units; Logistic Models; Male; Middle Aged; Parathyroid Hormone - blood; Prevalence; Prospective Studies; Sample Size; Surveys and Questionnaires; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - diagnosis; Vitamin D Deficiency - epidemiology; critical illness; vitamin D; critically ill patients; length of stay; mortality; hospital stay period; vitamin D deficiency; intensive care units
• ISSN: 1941-2452
• DOI: 10.1177/0884533616671741

Vitamin D deficiency is a prevalent condition among critically ill patients. Information about the relationship between vitamin D levels and outcomes in the intensive care unit (ICU) is sparse. To evaluate vitamin D status among critically ill patients and its relevance to severity of illness, ICU stay period, and mortality. This prospective multicenter study was conducted in the ICUs of Fayoum, Cairo, Alazhar, and Ain Shams university hospitals. All patients were subjected to interview questionnaire, laboratory investigation, vitamin D level assessment, and severity of illness evaluation using the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score. In total, 250 patients were included in the study. The median age was 62 (40-73) years, and most patients were male (52%). The median serum level of vitamin D was 19 (7-40.6). Vitamin D was deficient in 197 patients (78.8%) on admission. While we grouped the ICU patients as vitamin D deficient, insufficient, and sufficient, vitamin D-deficient patients had more severe diseases (mean APACHE II score, 44 ± 15; P = .014). Prolonged ICU stay was observed among the deficient group but with no significant association. The overall mortality rate was 6.8%; of these, 70.5% were vitamin D-deficient patients. However, logistic regression analysis demonstrated that vitamin D deficiency was not an independent risk factor for mortality. Vitamin D insufficiency is common in critically ill patients (69%); it is associated with more severity of illness, but it is not an independent risk factor for longer ICU stay or mortality.