Neither vitamin D levels nor supplementation are associated with the development of persistent critical illness: A retrospective cohort analysis

• Published in: Critical care and resuscitation Vol. 21; no. 1; pp. 39 - 44
• Main Authors: Viglianti, Elizabeth M, Zajic, Paul, Iwashyna, Theodore J, Amrein, Karin
• Format: Journal Article
• Language: English
• Published: Australia 01.03.2019
• Subjects: Critically ill; Intensive care units; Medical care; Metabolism; Safety measures; Vitamin D; Vitamin D deficiency
• ISSN: 1441-2772
• DOI: 10.1016/S1441-2772(23)00577-X

Objective: The purpose of this study was to evaluate if vitamin D deficiency is associated with increased rates of persistent critical illness, and whether repletion of vitamin D among patients with this deficiency leads to decreased persistent critical illness. Design: Retrospective cohort analysis. Setting: Seven intensive care units (ICUs) at the University Medical Center of Graz, Austria, with participants recruited between July 2008 and April 2010. The VITdAL-ICU trial cohort included five ICUs at the University Medical Center of Graz, Austria, with patients recruited between May 2010 through September 2012. Participants: There were 628 patients aged >= 18 years admitted to the ICU and who had their 25-hydroxyvitamin D (25(OH)D) level measured at least once. The VITdAL-ICU cohort included 475 patients aged >= 18 years who were expected to stay in the ICU for greater than 48 hours and found to have a 25(OH)D level of <= 20 ng/mL. Main outcome measures: Development of persistent critical illness. Results: In the retrospective cohort, vitamin D level on admission was not significantly associated with the development of persistent critical illness compared with patients who were discharged alive earlier (relative risk ratio [RRR], 1.02; 95% CI, 1.00-1.04) or who died (RRR, 1.02; 95% CI, 0.99-1.05). In the VITdAL-ICU trial, supplementation with vitamin D3 did not lead to less persistent illness relative to patients who were discharged alive earlier (RRR, 1.19; 95% CI, 0.79-1.80) or who died (RRR, 1.34; 95% CI, 0.72-2.52). Conclusion: Vitamin D deficiency was not associated with persistent critical illness, nor did supplementation with vitamin D3 mitigate the development of persistent critical illness.