Vitamin D deficiency is independently associated with mortality among critically ill patients

Moraes, Rafael Barberena; Friedman, Gilberto; Wawrzeniak, Iuri Christmann; Marques, Leonardo da Silva; Nagel, Fabiano Marcio; Lisboa, Thiago; Czepielewski, Mauro Antônio

doi:10.6061/clinics/2015(05)04

Cited by 50 publications

(45 citation statements)

References 38 publications

(55 reference statements)

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“…In our study population vitamin D level of 6.8 ng/ml was the best cutoff for identification of septic shock patients at a higher risk of death. The relationship between mortality and serum vitamin D levels in critically ill patients is a topic of debate in the current literature [39][40][41][42][43]. Our study is in agreement with some of the retrospective and prospective studies in the literature.…”

Section: A) B)supporting

confidence: 82%

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Sequential vitamin D and parathyroid hormone measurement in patients with septic shock: Could they be prognostic marker in septic shock

Yeter

Aktepe

Topeli

2018

j-ebr

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A B S T R A C T Aim:Hypocalcemia is a common clinical problem in critically-ill patients and it is associated with increased morbidity and mortality. The aim of this study was to investigate serum calcium, vitamin D and parathyroid hormone (PTH) levels in surviving and non-surviving septic shock patients. Method: Patients with septic shock criteria and who were older than 18 years of age were included, whereas patients with diseases influencing calcium homeostasis were excluded. Demographic and laboratory parameters were recorded prospectively. Results: 41 patients, 20 of which were male were included in the study. The median (min-max) age of study population was 67 (19-88) years. Frequency of hypocalcemia in the study population was 29.2% and 68.2% according to corrected calcium and ionized calcium, respectively. On the day septic shock was diagnosed (day 1), median vitamin D levels of survivors and non-survivors were 8.7 ng/ml (4.3-30.4) and 5.3 ng/ml (1.0-21.7), respectively (p=0.05). On the same day, median PTH levels of survivors and non-survivors were 94 ng/L (16.9-1746) and 49 ng/L (6.6-339), respectively (p=0.042). Although vitamin D levels were suppressed and PTH levels were elevated in non-survivors at day 5, this change was not statistically significant (p=0.19 and p=0.187). Conclusion: Hypocalcemia is frequent in septic shock patients, whereas vitamin D levels were low and PTH levels were high in the diagnosis day. These results suggest that vitamin D is suppressed by septic shock at non-surviving patients during course of septic shock. Parathyroid hormone may be a marker for worse outcome in critically ill patients.

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Section: A) B)supporting

confidence: 82%

“…Moraes RB. et al [42] suggested that vitamin D levels under 12 ng/ml remained an independent predictor of mortality at critically ill patients in their cohort study. As Moraes RB.…”

Section: A) B)mentioning

confidence: 99%

Sequential vitamin D and parathyroid hormone measurement in patients with septic shock: Could they be prognostic marker in septic shock

Yeter

Aktepe

Topeli

2018

j-ebr

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“…They also reported no significant differences between the groups in terms of mechanic ventilation requirement and nosocomial infection rates. They did not evaluate cortisol levels (11). In our study, the patients were not divided into groups according to vitamin D levels, and the mean vitamin D level was quite low.…”

Section: Discussionmentioning

confidence: 79%

“…It has been shown that low level of vitamin D has emerging association with severity of the disease, mortality, and short life span in the ICU patients. In some studies, it was shown to be associated with extension of mechanic ventilator dependency, increase in infection rate, and long stay in ICU (8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Initial cortisol levels and Vitamin D on Mortality and Hospital Infection Development in Geriatric Patients at Intensive Care Unit

Kutlucan¹,

Kutlucan²

2016

Acta Med Anatol

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Introduction: Vitamin D deficiency is a common problem throughout the world. Also vitamin D deficiency has been reported in up to 82% of patients in intensive care unit (ICU). In addition, corticosteroid insufficiency is a common problem in ICU patients. In this study, we investigated the effects of initial cortisol and vitamin D levels on mortality, hospital infection development and intubation status in geriatric ICU patients. Methods:This study was conducted in a tertiary ICU. In a one-year period, 117 consecutive ICU patients older than 65 years of age were evaluated retrospectively. Looking at the first with Vitamin D and cortisol levels of the patients were collected in the first 24 hours of hospitalization. At follow up period, relationship between these data's and mortality, hospital infection, and intubation conditions were evaluated.Results: Initial Vitamin D, the morning cortisol, and albumin levels were found to be significantly lower (respectively; p <0.001, p <0.001 and p <0.001), and lactate levels were found to be significantly higher (p <0.001) in patients who died in ICU than alive patients. Development rate of hospital-acquired infection was found to be significantly higher (p = 0.025) in patients with low vitamin D levels than alive patients. Vitamin D and cortisol levels were found to be lower and lactate levels were found to be higher (respectively: p <0.001, p = 0.004, p = 0.035) in intubated patients than alive patients. Conclusion:In geriatric patients, relationship between initial vitamin D and cortisol levels and mortality, hospital infection and intubation conditions were evaluated in our study for the first time. The low level of vitamin D is seen as an important risk factor for the mortality, development of hospital-acquired infections and intubation. Also it is determined that the low cortisol creates a negative situation in terms of mortality and intubation.

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“…10,11 Defisiensi vitamin D akan meningkatkan risiko kematian 1,9 kali lipat (CI =1,15-2,98; p=0,01) 12 dan kadar vitamin D 12 ng/ml merupakan cut of point peningkatan risiko kematian pada anak sakit kritis. 9 Defisiensi vitamin D menyebabkan peningkatan morbiditas dan mortalitas melalui efek pleiotropik terhadap fungsi multi organ, dan juga efek terhadap sistem imun, baik sistem imun alamiah ataupun adaptif. 7,8 Defisiensi vitamin D akan memicu terjadinya disfungsi multi organ pada pasien sakit kritis dan secara tidak langsung meningkatkan risiko morbiditas dan mortalitas.…”

Section: Hasil Dan Pembahasanunclassified

Hubungan status vitamin D dengan mortalitas dan lama rawatan pada anak sakit kritis

Rachmawati

Ihsan

2017

MKA

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AbstrakVitamin D memiliki peranan dalam pertahanan tubuh melawan infeksi. Vitamin D menghambat proliferasi sel otot polos vaskuler, melindungi endotel, dan memodulasi proses infeksi. Defisiensi vitamin D akan menyebabkan defek fungsi makrofag seperti kemotaksis, fagositosis, dan produksi sitokin pro-inflamasi. Defisiensi vitamin D akan memberikan luaran yang buruk pada anak sakit kritis. Tujuan: Untuk mengetahui hubungan kadar dan status vitamin D terhadap mortalitas dan lama rawatan pada anak sakit kritis. Metode: Studi potong lintang dilakukan di PICU RSUP M. Djamil Padang sejak Agustus sampai November 2016. Dilakukan penghitungan skor Pelod-2, pemeriksaan kadar serum vitamin D dan kalsium, dan dihubungkan dengan mortalitas serta lama rawatan. Hubungan antar variabel dianalisis statistik menggunakan t-Test, Mann-Whitney, Chi-square dan Kruskal-Wallis. Hasil: Diperoleh prevalensi insufisiensi dan defisiensi vitamin D pada anak sakit kritis adalah 37,50% dan 44,64%. Dari 56 subjek, 19 subjek meninggal dunia (33,92%). Skor Pelod 2 pada awal rawatan berhubungan dengan mortalitas (p=0,001). Tidak terdapat hubungan antara status vitamin D dengan mortalitas (p=0,732) dan lama rawatan (p=0,311) pada anak sakit kritis. Simpulan: Bahwa sebagian besar anak sakit kritis mengalami insufisiensi dan defisiensi vitamin D, namun status vitamin D tidak berhubungan dengan tingkat mortalitas dan lama rawatan. Kata kunci: defisiensi vitamin D; anak sakit kritis; mortalitas; lama rawatan Abstract Vitamin D has role in the body's defense against infection. Vitamin D inhibits proliferation of vascular smooth muscle cells, endothelial protect, and modulate the process of infection. Deficiency of vitamin D will cause defects of macrophage functions such as chemotaxis, phagocytosis and production of proinflammatory cytokines. Deficiency of vitamin D will provide poor outcomes in critically ill

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Vitamin D deficiency is independently associated with mortality among critically ill patients

Cited by 50 publications

References 38 publications

Sequential vitamin D and parathyroid hormone measurement in patients with septic shock: Could they be prognostic marker in septic shock

Sequential vitamin D and parathyroid hormone measurement in patients with septic shock: Could they be prognostic marker in septic shock

The Effects of Initial cortisol levels and Vitamin D on Mortality and Hospital Infection Development in Geriatric Patients at Intensive Care Unit

Hubungan status vitamin D dengan mortalitas dan lama rawatan pada anak sakit kritis

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