Addition of 25-hydroxyvitamin D levels to the Deyo-Charlson Comorbidity Index improves 90-day mortality prediction in critically ill patients
J Intensive Care. 2016; 4: 40, online 2016 Jun 17. doi: 10.1186/s40560-016-0165-0
PMCID: PMC4912797
Bisundev Mahato, Tiffany M. N. Otero, Carrie A. Holland, Patrick T. Giguere, Ednan K. Bajwa, Carlos A. Camargo, Jr., and Sadeq A. Quraishi
Vitamin D has been proven many times to reduce ICU mortality.
The items which are in both Intervention and Trauma/Surgery are listed here
- Traumatic Brain Injury – 120,000 IU of Vitamin D resulted in 3 fewer days on ventilators – RCT March 2020
- Surgeries outcomes far better if daily 50,000 IU of vitamin D for a week – Oct 2018
- Knee replacement not helped by 2,000 IU of vitamin D (both too late and too little) – RCT July 2018
- Heart attack ICU costs cut in half by Vitamin D – Oct 2018
- Urinary sepsis – a single Vitamin D injection reduced hospital days by 40 percent – RCT April 2018
- Ventilator-associated pneumonia death rate cut in half by Vitamin D injection (300,000 IU) – RCT July 2017
- ICU cost reduced by at least 27,000 dollars if get high dose vitamin D in first week - April 2017
- Vitamin D and Glutamine reduced Trauma Center deaths by half – March 2017
- Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016
- Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016
- 18 fewer hospital days if given 500,000 IU of vitamin D while ventilated in ICU – RCT June 2016
- ICU death rate reduced 3X when a vitamin D injection changed the PTH – Nov 2015
- Heart Attack ICU costs reduced $37,000 by $20 of Vitamin D – Nov 2015
- Vitamin D intervention increased by 20 percent the survival of critically ill patients- RCT June 2014
- Vitamin D aided progesterone in reducing traumatic brain injury – RCT Dec 2012
- Vitamin D reduces sepsis
Pages in BOTH of the categories: Trauma/Surgery and Mortality
- Cardiac Surgery with low vitamin D increased delirium 1.4X, mortality 1.5X – May 2020
- Ventilator-associated pneumonia death rate cut in half by Vitamin D injection (300,000 IU) – RCT July 2017
- Low Vitamin D when entering ICU is deadly (acute kidney injury in this case) – Aug 2017
- Increased Hospital, Sepsis deaths if low vitamin D – March 2014
- Vitamin D and Glutamine reduced Trauma Center deaths by half – March 2017
- Half of Swiss emergency patients had low vitamin D: length of stay, mortality, etc. – May 2016
- Chance of dying in hospital cut in half by just 10 ng higher level of Vitamin D – April 2016
- ICU patients 30 percent less likely to die if have enough vitamin D – meta-analysis Nov 2016
- Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016
- Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016
- Radio frequency ablation survival doubled with even modest levels of vitamin D – Feb 2016
- ICU death rate reduced 3X when a vitamin D injection changed the PTH – Nov 2015
- Risk of death within 90 days of ICU decreased by 16 percent for 1 nanogram extra vitamin D – June 2014
- ICU survival increased with vitamin D single 540K IU loading dose - JAMA Sept 2014
- Vitamin D intervention increased by 20 percent the survival of critically ill patients- RCT June 2014
- Hospital or ICU death about twice as likely if low vitamin D – March 2014
- 3X more likely to die within 3 months of being in ICU for 2 days if less than 20 ng vitamin D – Sept 2013
- Chance of dying within 1 month of entering hospital is 45 percent higher if low vitamin D – July 2013
- More sepsis deaths when active vitamin D (Calcitrol) was low – May 2013
- Off topic: Use of ICU in month before death has increased to almost 30 pcnt – Feb 2013
- Almost 6X more likely to die after coronary bypass if vitamin D deficient – Dec 2012
- Critically ill 70 percent more likely to die if vitamin D less than 15ng – Jan 2011
Wonder when ICUs will start adding Vitamin D?
- ICU improvements include
- Shorter recovery time
- Shorter ICU time
- Reduced deaths – in hospital, next month, next year
- Reduced Sepsis = blood poisoning = infection
 Download the PDF from Vitamin D Life
Background
The Deyo-Charlson Comorbidity Index (DCCI) has low predictive value in the intensive care unit (ICU). Our goal was to determine whether addition of 25-hydroxyvitamin D (25OHD) levels to the DCCI improved 90-day mortality prediction in critically ill patients.
Methods
Plasma 25OHD levels, DCCI, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were assessed within 24 h of admission in 310 ICU patients. Receiver operating characteristic curves of the prediction scores, without and with the addition of 25OHD levels, for 90-day mortality were constructed and the areas under the curve (AUC) were compared for equality.
Results
Mean (standard deviation) plasma 25OHD levels, DCCI, and APACHE II score were 19 (SD 8) ng/mL, 4 (SD 3), and 17 (SD 9), respectively. Overall 90-day mortality was 19 %. AUC for DCCI vs. DCCI + 25OHD was 0.68 (95 % CI 0.58–0.77) vs. 0.75 (95 % CI 0.67–0.83); p < 0.001. AUC for APACHE II vs. APACHE II + 25OHD was 0.81 (95 % CI 0.73–0.88) vs. 0.82 (95 % CI 0.75–0.89); p < 0.001. There was a significant difference between the AUC for DCCI + 25OHD and APACHE II + 25OHD (p = 0.04) but not between the AUC for DCCI + 25OHD and APACHE II (p = 0.12).
Conclusions
In our cohort of ICU patients, the addition of 25OHD levels to the DCCI improved 90-day mortality prediction compared to the DCCI alone. Moreover, the predictive capability of DCCI + 25OHD was comparable to that of APACHE II. Future prospective studies are needed to validate our findings and to determine whether the use of DCCI + 25OHD can influence clinical decision-making.
Chart from PDF
Chart from web
APACHE II Wikipedia