Effects of vitamin D deficiency in critically ill surgical patients

Presented at the 2011 annual meeting of the Midwest Surgical Association, Galena, Illinois.
The American Journal of Surgery; doi:10.1016/j.amjsurg.2011.09.012
Lisa Flynn M.D.a, Lisa Hall Zimmerman Pharm.D.b, Kelly McNorton Pharm.D.b, Mortimer Dolman M.D.c, James Tyburski M.D.a, Alfred Baylor M.D.a, Robert Wilson M.D.a, Heather Dolman M.D.a, hdolman at med.wayne.edu
a Department of Surgery, Wayne State University, School of Medicine, Detroit Receiving Hospital, Detroit Medical Center, Detroit, MI, USA
b Department of Pharmacy, Detroit Receiving Hospital, Detroit Medical Center, Detroit, MI, USA
c Department of Endocrinology, Mount Carmel East Hospital, Columbus, OH, USA
Received 25 July 2011; revised 25 September 2011; Available online 28 December 2011.

Background: The incidence of vitamin D deficiency in critically ill patients is reported to be up to 50%, with a 3-fold increase in predicted mortality, but limited data exist concerning vitamin D deficiency in critically ill surgical patients.

Methods Sixty-six adult surgical intensive care unit patients who had 25-hydroxyvitamin D serum levels evaluated from January 2010 to February 2011 were prospectively identified. Patients were divided into groups according to vitamin D level (<20 vs ?20 ng/mL).

Results Of the 66 patients evaluated, 49 (74%) had vitamin D levels < 20 ng/mL, and 17 (26%) had vitamin D levels >20 ng/mL.

Patients with vitamin D levels < 20 versus >20 ng/mL had longer lengths of hospital stay.
Lengths of intensive care unit stay were clinically longer, although not significant.
Infection rates tended to be higher (P = .09), and a higher incidence of sepsis was seen in the patients with vitamin D levels < 20 ng/mL.

Conclusions Vitamin D levels < 20 ng/mL have a significant impact on length of stay, organ dysfunction, and infection rates.
More data are needed on the value of supplementation to improve these outcomes.

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See also web

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• Random Controlled Trial: Sepsis and 2mg of Calcitriol
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