Critical Care Medicine: doi: 10.1097/01.ccm.0000424294.93940.c5, Oral Abstract Session
Moromizato, Takuhiro; Litonjua, Augusto; Braun, Andrea; Gibbons, Fiona; Giovannucci, Edward; Christopher, Kenneth
Introduction: Whether the degree of vitamin D deficiency affects survival following coronary artery bypass grafting (CABG) is not clear.
Hypothesis: We hypothesize that pre-hospital vitamin D deficiency is associated with mortality following CABG.
Methods: We performed a retrospective cohort study between 2001 and 2010 in two teaching hospitals in Boston, Massachusetts utilizing an institutional Research Patient Data Registry. We studied 322 patients, age = 18 years, in whom 25(OH)D was measured prior to hospitalization. The exposure of interest was pre-admission 25(OH)D categorized a priori as deficiency in 25(OH)D (=15ng/mL), insufficiency (15-30 ng/mL) and sufficiency (=30ng/mL). The primary outcome was all cause mortality 90 days following CABG. Vital status was obtained from the Social Security Administration Death Master File. Associations between vitamin D groups and mortality were estimated by bivariable and multivariable logistic regression models.
Results: Of the cohort, 15.1% were vitamin D deficient, 36.7% were insufficient and 48.2% were sufficient. 88.3% of cohort patients underwent cardiopulmonary bypass. 90-day mortality was 5.2%.
Pre-admission 25(OH)D deficiency is predictive for 90-day mortality following CABG.
Compared to patients with 25(OH)D sufficiency, patients with 25(OH)D deficiency have higher odds of mortality 90-days following CABG: 25(OH)D deficiency OR = 5.80 (95%CI, 1.33-25.21;p=0.02); 25(OH)D insufficiency OR = 4.17 (95%CI, 1.10-15.77;P=0.04); all relative to patients with vitamin D sufficiency. 25(OH)D in the cohort remains a significant predictor of 90-day mortality following adjustment for age, gender, race, acute kidney injury, acute myocardial infarction, pre-CABG hematocrit, glomerular filtration rate, and Deyo-Charlson index: 25(OH)D deficiency adjusted OR = 5.61 (95%CI, 1.17-26.9;p=0.03); 25(OH)D insufficiency adjusted OR = 3.87 (95%CI, 0.98-15.24;p=0.05); all relative to patients with vitamin D sufficiency. The vitamin D-mortality relationship is not materially confounded by cardiopulmonary bypass, concomitant valve surgery or re-operation status.
Conclusions: 25(OH)D deficiency prior to hospital admission is robustly associated with patient mortality following CABG.
(C) 2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins
Review of this study at MedPageToday Jan 2013