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ICU patients with pneumonia stay 7 days longer if low vitamin D - Dec 2011

Originally published December 2010, Supplemental Critical Care Medicine Journal.


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Vitamin D Deficiency for Pneumonia and Trauma Patients

Severe Vitamin D Deficiency Increases the Incidence, Length of Stay and Hospital Costs in Surgical Intensive Care Unit Patients with Ventilated-Associated Pneumonia

L. Ray Matthews, MD, Assistant Professor of Surgery, Morehouse School of Medicine,

Yusuf Ahmed, MD, MPH, Kenneth L. Wilson, MD, Assistant Professor of Surgery, Morehouse School of Medicine,

Diane D. Griggs, NP, Clinical Associate, Morehouse School of Medicine, Omar K.

Danner, MD, Assistant Professor of Surgery, Morehouse School of Medicine

ABSTRACT

Background:

Vitamin-D deficiency affects immune function in critically-ill patients. This study investigates the impact of vitamin-D deficiency in surgical intensive care unit (SICU) patients with ventilated-associated pneumonia (VAP).

Methods:

We performed a prospective assessment of the vitamin-D status on 191 patients admitted to the SICU between August 2009 and August 2010. Vitamin-D levels were measured by high pressure liquid chromatography (HPLC) and tandem mass spectrometry (Quest Lab). Vitamin D deficiency was defined as follows: severe <13; moderate 14-26; mild 27-39; and normal > 40 ng/ml.

Conclusion:

Severe vitamin-D deficiency increases VAP-incidence, LOS, and total hospital costs in SICU patients. Therefore, vitamin D deficiency should be corrected in critically-ill SICU patients expeditiously.

Background

Vitamin-D deficiency affects immune function in critically-ill patients. This study investigates the impact of vitamin-D deficiency in surgical intensive care unit (SICU) patients with ventilated-associated pneumonia (VAP).

Hypothesis

We hypothesize that severe vitamin-D deficiency increases the incidence, length of stay (LOS), hospital costs, and mortality rate in SICU patients with VAP.

Methods

We performed a prospective assessment of the vitamin-D status on 191 patients admitted to the SICU between August 2009 and August 2010. Vitamin-D levels were measured by high pressure liquid chromatography (HPLC) and tandem mass spectrometry (Quest Lab). Vitamin D deficiency was defined as follows: severe <13; moderate 14-26; mild 27-39; and normal > 40 ng/ml.

Results

Of the 191 patients, 129 (67.5%) were male, and 62 (32.5%) were female, 118 (61.8%) were African-Americans and 73 (38.2 %) were Caucasian. 62.3% were severe vitamin D deficiency, 29.3% moderate deficiency, and 6.8% mild deficiency. The incidence of VAP in the severe group was 30.3% versus 16 % in the non-severe (moderately & mildly deficiency) group (p value, 0.040). Mean LOS in the SICU for severely deficient group was 13.7 days versus 5.9 days. Average ICU cost was $68,862.52 for severe group with VAP versus $31,743.56 (p value, 0.001). Mortality rate for the severe vitamin D deficient group with VAP was 10.9% versus 5.6%, (p value, 0.220), a trend towards higher mortality.

Severe Vit-D Deficient

Moder/Mild Vit-D

P_Value

(N=119)

Deficient (N=72)

Male

60.5%

79.2%

0.008

Female

39.5%

20.8%

Black

72%

44.4%

0.000

White

27.0%

55.6%

Intubated

54.6%

25.0%

0.005

Pneumonia

30.0%

16.0%

0.04

Mortality

10.9%

5.6%

0.220

Severe Vit-D Deficient

Moderate/Mild Vit-D Deficient

Mean ± SEM

Mean ± SEM

P_Value

Age (Years)

47.13 ± 1.7

46.69± 2.1

NS

Vitamin_D Level(ng/ml)

8.04±0.28

21.83±0.97

0.000

Length of ICU Stay

13.73±0.94

5.88± 1.3

0.000

ICU Cost($)

$52,935.± 7,496.

$22,688.± 4,839.

0.000

VAP_ICU_Cost ($)

$68,862.±8,199.

$31,743.±5,345.

0.001

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See also VitaminDWiki

Attached files

ID Name Comment Uploaded Size Downloads
1141 Vitamin D Deficiency for Pneumonia and Trauma Patients_VAP.pdf PDF poster admin 08 Mar, 2012 23:37 538.41 Kb 957
1140 Vitamin D Deficiency for Pneumonia and Trauma Patients_VAP-1.jpg top admin 08 Mar, 2012 23:33 15.60 Kb 1089
1139 Matthews poster.jpg admin 08 Mar, 2012 23:32 17.91 Kb 1037
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