Association Between the Circulating Level of 25-Hydroxyvitamin D and Clinical Results After Cardiac Surgery: A Meta-Analysis and Systematic Review
Front Cardiovasc Med. 2021 Nov 15;8:734504. doi: 10.3389/fcvm.2021.734504
Yulin Zhang 1, Jiawen Li 1, Yu Qiu 1, Xue Gong 1, Yunru He 1, Peng Yue 1, Xiaolan Zheng 1, Lei Liu 1, Hongyu Liao 1, Kaiyu Zhou 1, Yimin Hua 1, Yifei Li 1
Background: Vitamin D (VitD) is an important pleiotropic hormone for organ systems. Studies have focused on the level of VitD, especially that of 25-hydroxyvitamin D (25-(OH)-VitD), in patients after cardiac surgery and the relationship between VitD deficiency and adverse outcomes, but the results have been inconsistent. We carried out a meta-analysis to evaluate differences in the 25-(OH)-VitD level before and after cardiac surgery, and evaluated the predictive value of 25-(OH)-VitD level in the clinical outcomes of patients undergoing cardiac surgery.
Methods: Studies related to VitD level and cardiac surgery were searched from PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials databases from inception to October 2020. We applied the Newcastle-Ottawa Scale to assess the risk of a bias in individual studies. We examined the heterogeneity and publication bias and performed subgroup analyses and sensitivity analyses.
Results: Fifteen studies were included in our analysis. The 25-(OH)-VitD level was significantly lower immediately after surgery [stand mean difference (SMD), 0.69; 95%CI (0.1, 1.28), P = 0.023] and 24-h after surgery [0.84; (0.47, 1.21), 0.000] compared with that before surgery. A higher prevalence of 25-(OH)-VitD deficiency was recorded 24 h after surgery [RR, 0.59; 95%CI (0.47, 0.73), P = 0.00]. Pooled results demonstrated a significant relationship between the preoperative 25-(OH)-VitD level and vasoactive-inotropic score (VIS) [SMD, -3.71; 95%CI (-6.32, -1.10); P = 0.005], and patients with 25-(OH)-VitD deficiency revealed a comparatively poor prognosis and severe condition after cardiac surgery [-0.80; (-1.41, -0.19), 0.01]. However, 25-(OH)-VitD deficiency was not associated with the duration of stay in the intensive care unit.
Conclusions: Cardiac surgery would leads to deficiency of 25-(OH)-VitD. And the preoperative and postoperative levels of 25-(OH)-VitD are associated with adverse events, which is eligible to work as an indicator to demonstrate clinical outcomes.
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Other surgeries
- Surgeries often deplete Vitamin D - 300,000 IU resulted in little response – Nov 2018
- Critical illness – Vitamin D levels start low and then drop for several days – Feb 2018
- After hip surgery Vitamin D levels dropped by 32 percent – Sept 2018
- Vitamin D is Way More Important in Critical Care Than We May Have Recognized - June 2017
- Pro-inflammatory cytokines cause the 74 percent drop in vitamin D after knee arthroplasty – Feb 2014
Heart Surgeries
- Vitamin D levels dropped 42 percent immediately after pediatric cardiac surgery – Dec 2019
- Taking Vitamin D just before and after surgery helps (open-heart in this case) – RCT Feb 2021
- Congenital Heart problems - vitamin D levels drop even lower after surgery, loading dose probably required - thesis 2015
- Congenital heart surgery dropped vitamin D levels by 40 percent – July 2013
Vitamin D Life - Trauma and surgery category has
Trauma and Surgery category hasLarge dose Vitamin D before surgery was found to help by 35 studies
Vitamin D is needed before most surgeries – many studies and RCTs
4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024
Sepsis is both prevented and treated by Vitamin D - many studies
Thyroidectomy and Vitamin D - many studies
Orthopaedic surgeries need Vitamin D – many studies
Cancer - After diagnosis chemotherapy
TBI OR "Traumatic Brain Injury - 21 in title as of Sept 2022
Superbug (Clostridium difficile) Infections strongly associated with low vitamin D - many studies
Glutamine and Omega-3 have also been proven to help several traumas/surgeries
Note: Vitamin D also prevents the need for various surgeries and Omega-3 prevents many concussions/TBI
Trauma and Surgery is associated with 22 other Vitamin D Life categories
Such as loading dose 33, Mortality 23, Infant-Child 21 Intervention 19 Cardiovascular 13, Injection 13 in Sept 2022
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