1048

Abstract

difference in length of stay or acute kidney injury. However, patients receiving 100% BF had a shorter duration of vasopressor use (1.0 vs 1.3 days, p=0.012) and lower mortality (13% vs 15%, p=0.046, OR=0.79, 95% CI 0.63, 0.996) compared to those receiving 100% UF. Conclusions: In this large cohort of PSS patients, use of BF for bolus resuscitation was associated with shorter vasopressor duration and improved survival compared to use of UF. These findings have potential implications for PSS management and future trials.Learning Objectives: Vitamin D is an important immune modulator. While current literature supports that vitamin D deficiency is associated with increased mortality in septic patients, the effect of vitamin D supplementation prior to admission for sepsis is unknown. The purpose of this study is to evaluate the relationship between vitamin D supplementation prior to admission for sepsis to determine the impact on mortality. Methods: This was a retrospective cohort of patients ≥18 yr admitted from January 1, 2010 to December 31, 2013 with a diagnosis of severe sepsis or septic shock. Patients who received vitamin D supplementation for at least 7 days prior to admission were compared those who did not. Data was collected on age, race, gender, comorbidities, source of infection, APACHE II, vasopressors, hydrocortisone, mortality and length of stay. The primary endpoint was 30 day mortality. Univariate analysis with Chi-square, Fisher's exact test or t-test was performed. Multivariate logistic regression analysis was conducted. Results: Of the 446 patients evaluated in this study, 413 (92.6%) were included, of which 271 (65.6%) were not on vitamin D supplementation and 142 (34.4%) were on egrocalciferol or cholecalciferol. Baseline demographics were similar between groups, except supplemented patients had higher incidence of coronary artery disease (25.8% vs 41.5%, p<0.001), hypertension (42.4% vs 62%, p<0.001) and chronic kidney disease (35.8% vs 47.9%, p<0.001). Serum concentrations of 25-hydroxyvitamin D were higher in supplemented patients (21.5 vs 31.3 ng/mL, p=0.004). There was no difference in 30 day mortality (37.2% non-supplemented vs. 28.6% supplemented, p=0.082). After adjusting for confounders with multivariate logistic regression analysis, vitamin D supplementation was not associated with less 30 day mortality (p=0.113). Conclusions: Though vitamin D deficiency is associated with increased mortality in septic patients, it does not appear that vitamin D supplementation prior to admission for sepsis improves mortality.