The relationship between immediate preoperative serum 25-hydroxy-vitamin D3 levels and cardiac function, dysglycemia, length of stay, and 30-d readmissions in cardiac surgery patients

Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients

“…Epidemiologic evidence exists linking vitamin D insufficiency with glycemic status as well as impairment of pancreatic secretion of insulin and increased insulin resistance in nonburned populations 18 . ‐ 21 , 24 , 46 ‐ 48 On the other hand, Sriram et al 49 reported in adult post–cardiac surgery patients that low D 3 levels had no correlation to dysglycemia. Relative to the current study, questions remain, such as the following: Did the sepsis precipitate hyperglycemia?…”

Serum Total 25‐OH Vitamin D Adds Little Prognostic Value in Patients Undergoing Coronary Catheterization

“…13 In contrast, other studies have not found associations with postoperative mortality or cardiac comorbidities (eg, arrhythmias, low cardiac output) in cardiac surgery patients, 14,15 perhaps because of small sample sizes and presence of competing risk factors. Interestingly, serum 25-OH and 1,25 (OH) 2 vitamin D fluctuate during hospital stays 16 and following cardiac surgery, 15,30 likely due to fluid administration. This finding clearly supports measuring 25-OH vitamin D in the pre-procedural rather than peri-or post-procedural states, and may explain heterogeneity between studies.…”

“…Furthermore, in a study of 3371 patients undergoing coronary artery bypass grafting or valve surgery, 25‐OH vitamin D was inversely associated with postoperative cardiac complications including in‐hospital death, myocardial infarction, low output syndrome, and stroke . In contrast, other studies have not found associations with postoperative mortality or cardiac comorbidities (eg, arrhythmias, low cardiac output) in cardiac surgery patients, perhaps because of small sample sizes and presence of competing risk factors. Interestingly, serum 25‐OH and 1,25 (OH) 2 vitamin D fluctuate during hospital stays and following cardiac surgery, likely due to fluid administration.…”

“…9 As such, 25-OH vitamin D could still be valuable as a clinical prognostic marker. 8,[10][11][12] While several clinical studies have evaluated the association between 25-OH vitamin D and risk of CVD outcomes, complications, and mortality following surgery or hospitalization, [13][14][15][16][17][18][19][20] few have fully evaluated the prognostic value of 25-OH vitamin D by contrasting model discrimination, fit, and calibration to those from models containing established risk factors. Furthermore, none have examined the ability of 25-OH vitamin D to appropriately reclassify patient risk when added to models containing established risk factors.…”

The ongoing story of vitamin D

“…12 In over 90% of our cohort, in both deficient (< 20 ng/mL) and normal groups, 25-OH Vit D 3 levels fell on the first postoperative day (p<0.001). This is most likely due to hemodilution.…”