Sepsis death 2.4 X more likely if low Vitamin D - Oct 2022
Vitamin D deficiency on admission to the emergency department is a mortality predictor for patients with septic shock treated with early protocol-driven resuscitation bundle therapy
The American Journal of the Medical Sciences Clinical Investigation https://doi.org/10.1016/j.amjms.2022.10.005 PDF is behind a paywall
BoraChaeMD, PhDYoun-JungKimMD, PhDSang MinKimMDSeok-InHongMDYo SepShinMDJune-SungKimMD, PhDSeung MokRyooMD, PhDWon YoungKimMD, PhD
Vitamin D is an important immune modulator and is associated with susceptibility to infection. However, past studies have reported inconsistent results regarding the association between vitamin D deficiency and mortality in patients with sepsis, and early-stage data regarding septic shock are limited. This study aimed to determine the relationship between vitamin D deficiency on admission to the emergency department (ED) and mortality in patients with septic shock.
Methods
We analyzed prospectively collected data on adult patients with septic shock who were treated with protocol-driven resuscitation bundle therapy in the ED between September 2019 and February 2021. Septic shock was defined by the sepsis-3 definition and vitamin D deficiency was defined as a 25-hydroxyvitamin D <20 ng/ml. The primary outcome was 30-day mortality.
Results
A total of 302 patients were included, 236 (78.1%) patients had vitamin D deficiency; it was significantly higher in non-survivors than in survivors (89.3% vs. 73.9%, P=0.004). Mortality was higher in vitamin D deficient patients than in non-deficient patients (31.8% vs. 13.6%, P=0.004). In multivariate analysis, vitamin D deficiency (odds ratio [OR], 2.43; 95 % confidence interval CI, 1.03–5.74), hyperlactatemia (OR, 3.65; 95 % CI, 1.95–6.83), Sequential Organ Failure Assessment scores (OR, 1.22; 95% CI, 1.09–1.36), and albumin levels (OR, 0.39; 95% CI, 0.21–0.73) were significantly associated with 30-day mortality.
Conclusions
Vitamin D deficiency was prevalent in patients with septic shock visiting the ED and was associated with mortality.
Sepsis death 2.4 X more likely if low Vitamin D – Aug 2022
Severe vitamin D deficiency in patients admitted to the emergency department with severe sepsis is associated with an increased 90-day mortality
Emergency Medicine http://dx.doi.org/10.1136/emermed-2021-211973
Stefano Malinverni1 stefano_malinverni at stpierre-bru.b, Queitan Ochogavia1, Sarah Lecrenier1, Margherita Scorpinniti2, Jean-Charles Preiser3, Frederic Cotton4, Pierre Mols1, Magali Bartiaux1
Background The role of vitamin D in the response to infection has been increasingly acknowledged. However, the influence of severe vitamin D deficiency on the outcome of patients admitted for severe sepsis is unknown. Hence, this study aimed to investigate the association between severe vitamin D deficiency and sepsis-related outcomes in patients presenting to the ED.
Methods This single centre prospective study included patients presenting to the ED with severe sepsis from April 2014 until December 2017. 25-Hydroxy vitamin D (25(OH)D) was measured in a blood sample drawn within 24 hours of admission to the ED, and severe vitamin D deficiency was defined as 25(OH)D <12 ng/mL. 90-day mortality was compared between patients with and without severe vitamin D deficiency by a multivariable analysis adjusting for confounders and according to a Kaplan-Meier survival analysis.
Results 263 patients were initially screened and 164 patients with severe sepsis were included in this study, 18% of whom had septic shock. Severe vitamin D deficiency was present in 46% of patients. The overall 90-day mortality rate was 26.2% and the median length of stay was 14 days.
In a logistic regression accounting for sepsis severity and age-adjusted comorbidities, severe vitamin D deficiency was associated with increased mortality (OR=2.69 (95% CI 1.03 to 7.00), p=0.043), and lower chances of hospital discharge (sub-HR=0.66 (95% CI 0.44 to 0.98)). In the subgroup of patients admitted to the intensive care unit, severe vitamin D deficiency was associated with an increased 28-day adjusted mortality (HR=3.06 (95% CI 1.05 to 8.94), p=0.04) and lower chances of discharge (sub-HR=0.51 (95% CI 0.32 to 0.81)).
Conclusions Severe vitamin D deficiency at ED admission is associated with higher mortality and longer hospital stay in patients with severe sepsis.
Download the PDF from Research Gate Vitamin D Life
Severely low vitamin D : <12 ng
Spreadsheet of data: 164 rows. >40 columns - includes age, vitamin D levels, etc.
from FigShare Spreadsheet
Vitamin D Life pages with SEPSIS in title (35 as of Aug 2022)
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