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1.5X increased infection, sepsis, and death if in ICU with low vitamin D - Meta-analysis Dec 2014

Two meta-studies from the same Journal issue are on this page: they agree on mortality

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The TOP (most read) articles in Trauma and Surgery and Vitamin D are::

Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: systematic review and meta-analysis.

Crit Care. 2014 Dec 5;18(6):660. [Epub ahead of print]
de Haan K k.dehaan at erasmusmc.nl , Groeneveld A, de Geus H, Egal M, Struijs A.

VitaminDWiki Summary

ICU with < 20 ng of vitamin D
Infection increased 1.5X
Sepsis increased 1.5X
Death increased 1.8X

Introduction: In Europe, vitamin D deficiency is highly prevalent varying between 40% to 60% in the healthy general adult population. The consequences of vitamin D deficiency for sepsis and outcome in critically ill patients remains controversial. We therefore systematically reviewed observational cohort studies on vitamin D deficiency on the intensive care unit.

Methods: Fourteen observational reports published from January 2000 to March 2014, retrieved from Pubmed and Embase, involving 9,715 critically ill patients and serum 25-hydroxyvitamin D3 (25 (OH)-D) concentrations, were meta-analysed.

Results: Levels of 25 (OH)-D less than 50 nmol/L were associated with increased rates of infection (risk ratio (RR) 1.49, 95% (confidence interval (CI) 1.12 to 1.99), P =0.007), sepsis (RR 1.46, 95% (CI 1.27 to 1.68), P <0.001), 30-day mortality (RR 1.42, 95% (CI 1.00 to 2.02), P =0.05), and in-hospital mortality (RR 1.79, 95% (CI 1.49 to 2.16), P <0.001). In a subgroup analysis of adjusted data including vitamin D deficiency as a risk factor for 30 day-mortality the pooled RR was 1.76 (95% CI 1.37 to 2.26, P <0.001).

Conclusions: This meta-analysis suggests that vitamin D deficiency increases susceptibility for severe infections and mortality of the critically ill.
PMID: 25475621
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Association between vitamin D deficiency and mortality in critically ill adult patients: a meta-analysis of cohort studies

Critical Care 2014, 18:684 doi:10.1186/s13054-014-0684-9 Published: 12 December 2014
Yan-Peng Zhang1, You-Dong Wan1, Tong-Wen Sun1*, Quan-Cheng Kan2* and Le-Xin Wang3*
Corresponding authors: Tong-Wen Sun suntongwen at 163.com - Quan-Cheng Kan 1017361289 at qq.com - Le-Xin Wang LWang at csu.edu.au
Abstract (provisional)
Introduction Vitamin D deficiency is common in critically ill patients, and was reported to be associated with adverse outcomes. However, the effect of vitamin D deficiency on mortality in critically ill patients remains unclear.

Methods We searched PubMed and EMBASE from the inception to July 2014 for cohort studies to assess the effect of vitamin D deficiency on the incidence of mortality in critically ill patients. Mortality-specific odds ratio (OR) with 95% confidence interval (CI) were pooled with a random- or fixed-effect models when appropriate.

Results Seven cohort studies with a total of 4,204 participants including 1,679 cases of vitamin D deficiency were included in this meta-analysis.
Vitamin D deficiency was significantly associated with an increased hospital mortality (OR 1.76; 95% CI, 1.38 to 2.24; P <0.001), with very low heterogeneity (I 2?=?2.3%; P =0.402).
The finding of increased hospital mortality in critically ill adult patients was consistently found in every stratum of our subgroup analyses.

Conclusions This meta-analysis suggests that vitamin D deficiency is associated with increased incidence of hospital mortality in critically ill adult patients.
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Attached files

ID Name Comment Uploaded Size Downloads
4718 Zang.jpg admin 12 Dec, 2014 14:07 40.55 Kb 799
4717 Critical Care Zang Dec 2014.pdf PDF 2014 admin 12 Dec, 2014 13:56 734.25 Kb 893
4695 ICU T1.jpg admin 07 Dec, 2014 23:46 133.83 Kb 768
4694 ICU meta-analysis.pdf PDF 2014 admin 07 Dec, 2014 23:45 858.00 Kb 780
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