Association between pre-hospital vitamin D status and hospital-acquired new-onset delirium
British Journal of Nutrition, http://dx.doi.org/10.1017/S0007114515001245
(Received August 05 2014), (Revised February 07 2015), (Accepted March 17 2015), Published online: 21 April 2015
Sadeq A. Quraishi a1a2, Augusto A. Litonjua a3a4, Kevin M. Elias a5, Fiona K. Gibbons a3a6, Edward Giovannucci a7a8, Carlos A. Camargo Jr a3a8a9 and Kenneth B. Christopher a3a10
1 Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
2 Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
3 Department of Medicine, Harvard Medical School, Boston, MA, USA
4 Channing Division of Network Medicine and Pulmonary and Critical Care Division, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA
5 Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA
6 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
7 Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
8 Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
9 Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
10 The Nathan E. Hellman Memorial Lab., Renal Division, Dept of Medicine, Brigham and Women's Hospital, 75 Francis Street, MRB 418, Boston, MA 02115, USA kbchristopher at partners.org
HANOD = hospital-acquired new-onset delirium
The goal of the present study was to determine whether pre-hospital 25-hydroxyvitamin D (25(OH)D) levels are associated with the risk of hospital-acquired new-onset delirium (HANOD). We performed a retrospective cohort study of 4508 adult inpatients at two teaching hospitals in Boston from 1993 to 2006. All patients had 25(OH)D levels measured before hospital admission. The main outcome measure was HANOD, defined as the onset of delirium during an acute care hospitalisation. Patients with a history of delirium or dementia, or those with a diagnosis of delirium or dementia upon acute care hospitalisation were excluded from the analysis. To test the association of pre-hospital 25(OH)D levels with HANOD, we constructed a multivariable logistic regression model to adjust for clinically relevant covariates. Among our patient cohort, the mean 25(OH)D level was 22 (sd 13) ng/ml and approximately 4 % of patients met the criteria for HANOD.
Following adjustment for age, sex, race (non-white v. white), patient type (medical v. surgical) and Deyo–Charlson Index, patients with 25(OH)D levels < 10, 10–19·9 and 20–29·9 ng/ml had higher odds of HANOD than patients with 25(OH)D levels ≥ 30 ng/ml: OR 2·15 (95 % CI 1·32, 3·50), OR 1·54 (95 % CI 0·98, 2·43) and OR 1·23 (95 % CI, 0·76, 1·99), respectively. These data support the rationale for randomised, controlled trials to test the role of vitamin D supplementation in the prevention of HANOD.
Download the PDF from Vitamin D Life
See also Vitamin D Life
- Cardiac Surgery with low vitamin D increased delirium 1.4X, mortality 1.5X – May 2020
- Delirium 24 percent more likely for each 2.5 ng lower vitamin D (313,000 patients) – Feb 2019
- 2X more likely to get hospital infection if low vitamin D (10 ng) when enter – Oct 2013 - Quraishi is a co-author of this as well
- Delirium 2.7 X more likely after hip fracture and low vitamin D – May 2015
- Delirium in Hospitalized Older Adults (does not mention low vitamin D relationship) NEJM Oct 2017
- Postoperative cognitive dysfunction 8 X more likely if low vitamin D – March 2018
Nutraingredients has a review of the study
Those developing HANOD (associated with low vitamin D) stayed in hospital 4-13 days longer and were 2X more likely to die.