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Vitamin D and ICU outcome in septic patients: a difficult connection?
Critical Care volume 18, Article number: P246 (2014)
In a 10-bed general ICU at the emergency department of a tertiary teaching hospital in Florence (Italy), 71 medical patients with severe sepsis or septic shock (51% men, 40% women) admitted to the ICU between January 2013 and September 2013 were studied. Vitamin D levels were measured by radioimmunoassay at admission, as well as demographic data (Table 1) and the Simplified Acute Physiology Score II (SAPS II). Exclusion criteria were: age <18 years, malnutrition state (body mass index (BMI) <18 kg/m2), pregnancy. Statistical analysis was carried out by linear regression and t test with SPSS 13. This study was approved by the Internal Review Board. Informed consent was obtained.
Most patients showed vitamin D levels below 20 ng/ml, and we have not demonstrated a statistical significance correlation in the univariate regression between vitamin D level and both SAPS (P = 0.300) or length of stay in hospital (P = 0.154). Also our data do not demonstrate a statistical significance difference at t test between the value of vitamin D in the dead group and the alive group.
Several groups have reported an inverse association between vitamin D levels in critically ill patients, severity of disease, outcome length of ICU stay and mortality [3, 4]. In our experience we have not found an evident correlation between low vitamin levels and ICU outcomes. However, considering the prevalence of low vitamin D levels among the medical patients admitted to the ICU, further studies should be performed.
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Lucidarme O, et al.: Incidence and risk factors of vitamin D deficiency in critically ill patients: results from a prospective observational study. Intensive Care Med 2010, 36: 1609-1611. 10.1007/s00134-010-1875-8
McKinney JD, et al.: Relationship between vitamin D status and ICU outcomes in veterans. J Am Med Dir Assoc 2011, 12: 208-211. 10.1016/j.jamda.2010.04.004
Higgins DM, et al.: Relationship of vitamin D deficiency to clinical outcomes in critically ill patients. J PEN J Parenter Enteral Nutr 2012, 36: 713-720. 10.1177/0148607112444449
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Socci, F., Cecchi, A., Di Valvasone, S. et al. Vitamin D and ICU outcome in septic patients: a difficult connection?. Crit Care 18, P246 (2014). https://doi.org/10.1186/cc13436
- Severe Sepsis
- Septic Patient
- Medical Patient
- Acute Physiology Score
- Alive Group