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

Nutr Clin Pract. 2017 Jun;32(3):378-384. doi: 10.1177/0884533616671741. Epub 2016 Oct 21.

Abstract

Background: 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.

Purpose: To evaluate vitamin D status among critically ill patients and its relevance to severity of illness, ICU stay period, and mortality.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: critical illness; critically ill patients; hospital stay period; intensive care units; length of stay; mortality; vitamin D; vitamin D deficiency.

Publication types

  • Multicenter Study

MeSH terms

  • 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*

Substances

  • Parathyroid Hormone
  • Vitamin D