Vitamin D deficiency is highly prevalent in malnourished inpatients and associated with higher mortality

Abstract

The impact of vitamin D deficiency on the recovery of patients with malnutrition remains undefined. Our aim was to study the prevalence of vitamin D deficiency in a well-characterized cohort of patients with malnutrition and its association with outcomes. Within this secondary analysis of a randomized controlled trial, we examined the association of vitamin D deficiency and adverse clinical outcomes over a follow-up of 180 days in hospitalized patients at risk for malnutrition. We measured 25-hydroxyvitamin D levels upon admission and defined Vitamin D deficiency when levels were <50nmol/l. The primary endpoint was 180-day mortality. The prevalence of vitamin D deficiency in our cohort of 828 patients was 58.2% (n = 482). Patients with vitamin D deficiency had increased 180-day mortality rates from 23.1% to 29.9% (odds ratio 1.42, 95% confidence interval [CI] 1.03–1.94, P = .03). When adjusting the analysis for demographics, comorbidities, and randomization, this association remained significant for the subgroup of patients not receiving vitamin D treatment (adjusted odds ratio 1.63, 95% CI 1.01–2.62, P = .04). There was no significantly lower risk for mortality in the subgroup of vitamin D deficient patients receiving vitamin D treatment compared to not receiving treatment (adjusted odds ratio 0.74, 95% CI 0.48–1.13, P = .15). Vitamin D deficiency is highly prevalent in the population of malnourished inpatients and is negatively associated with long-term mortality particularly when patients are not receiving vitamin D treatment. Our findings suggest that malnourished patients might benefit from vitamin D screening and treatment in case of deficiency.

Supplementation of the population during the COVID-19 pandemic with vitamins and micronutrients – how much evidence is needed?

“…It has been estimated by the Swiss Federal Office of Public Health that large parts of the Swiss population have inadequate serum 25-hydroxy-vitamin D (25(OH)D) concentrations, particularly among the elderly, frail population. For example, a recent clinical multicentre study found that 60% of multimorbid medical inpatients had deficient vitamin D levels (<50 nmol/l) on admission and 25% were severely deficient (<25 nmol/l) [8]. In this study, vitamin D deficiency was associated with a 30% increase in mortality risk in a statistical regression model adjusted for demographics and comorbidities.…”

Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: secondary analysis of a prospective randomized trial

“…The trial protocol and the results of the main trial, as well as secondary outcomes, have been published previously. [4,11,[16][17][18][19][20][21][22] The Ethics Committee of Northwest and Central Switzerland (EKNZ) approved the study protocol in January 2014 (EKNZ; 2014_001).…”

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“…Older adults 65þ deficient vitamin D levels at hospital admission, which was associated with higher mortality [111]. The prevalence of vitamin D insufficiency was highest in winter (JanuaryeMarch) with more than nine out of ten men being vitamin D deficient and/or insufficient [112].…”