Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder-A Nationwide Study
Medicines (Basel). 2020 Nov 22;7(11):E72. doi: 10.3390/medicines7110072.
Urvish Patel 1, Salma Yousuf 1, Komal Lakhani 2, Payu Raval 3 4, Nirmaljot Kaur 5, Toochukwu Okafor 6, Chail Shah 7 8, Harmandeep Singh 5, Mehwish Martin 1, Chika Nwodika 9, Angelina Yogarajah 10, Jigisha Rakholiya 11, Maitree Patel 12, Raja Chandra Chakinala 13, Shamik Shah 14
Background: According to past studies, recovery and survival following severe vascular events such as acute myocardial infarction and stroke are negatively impacted by vitamin D deficiency. However, the national estimate on disability-related burden is unclear. We intend to evaluate the prevalence and outcomes of vitamin D deficiency (VDD) among patients with cardiovascular disease (CVD) and cerebrovascular disorder (CeVD).
Methods: We performed a cross-sectional study on the Nationwide Inpatient Sample data (2016-2017) of adult (≥18 years) hospitalizations. We identified patients with a secondary diagnosis of VDD and a primary diagnosis of CVD and CeVD using the 9th revision of the International Classification of Diseases, clinical modification code (ICD-10-CM) codes. A univariate and mixed-effect multivariable survey logistic regression analysis was performed to evaluate the prevalence, disability, and discharge disposition of patients with CVD and CeVD in the presence of VDD.
Results: Among 58,259,589 USA hospitalizations, 3.44%, 2.15%, 0.06%, 1.28%, 11.49%, 1.71%, 0.38%, 0.23%, and 0.08% had primary admission of IHD, acute MI, angina, AFib, CHF, AIS, TIA, ICeH, and SAH, respectively and 1.82% had VDD.
The prevalence of hospitalizations due to:
- CHF (14.66% vs. 11.43%),
- AIS (1.87% vs. 1.71%), and
- TIA (0.4% vs. 0.38%)
was higher among VDD patients as compared with non-VDD patients (p < 0.0001).
In a regression analysis, as compare with non-VDD patients, the VDD patients were associated with higher odds of discharge to non-home facilities with an admission diagnosis of
- CHF (aOR 1.08, 95% CI 1.07-1.09),
- IHD (aOR 1.24, 95% CI 1.21-1.28),
- acute MI (aOR 1.23, 95% CI 1.19-1.28),
- AFib (aOR 1.21, 95% CI 1.16-1.27), and
- TIA (aOR 1.19, 95% CI 1.11-1.28).
VDD was associated with higher odds of severe or extreme disability among patients hospitalized with
- IS (aOR 1.1, 95% CI 1.06-1.14),
- ICeH (aOR 1.22, 95% CI 1.08-1.38),
- TIA (aOR 1.36, 95% CI 1.25-1.47),
- IHD (aOR 1.37, 95% CI 1.33-1.41),
- acute MI (aOR 1.44, 95% CI 1.38-1.49),
- AFib (aOR 1.10, 95% CI 1.06-1.15), and
- CHF (aOR 1.03, 95% CI 1.02-1.05) as compared with non-VDD.
Conclusions: CVD and CeVD in the presence of VDD increase the disability and discharge to non-home facilities among USA hospitalizations. Future studies should be planned to evaluate the effect of VDD replacement for improving outcomes.
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