Low vitamin d concentration is not associated with increased mortality and morbidity after cardiac surgery.
PLoS One. 2013 May 28;8(5):e63831. doi: 10.1371/journal.pone.0063831. Print 2013.
Turan A, Grady M, You J, Mascha EJ, Keeyapaj W, Komatsu R, Bashour CA, Sessler DI, Saager L, Kurz A.
Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, United States of America.
OBJECTIVE: To determine the effect of vitamin D on postoperative outcomes in cardiac surgical patients.
DESIGN: Retrospective study.
SETTING: Single institution-teaching hospital.
PARTICIPANTS: Adult cardiac surgical patients with perioperative 25-hydroxyvitamin D measurements.
INTERVENTIONS: None. We gathered information from the Cardiac Anesthesiology Registry that was obtained at the time of the patients' visit/hospitalization.
MEASUREMENTS AND MAIN RESULTS:
We used data of 18,064 patients from the Cardiac Anesthesiology Registry; 426 patients with 25-hydroxyvitamin D measurements met our inclusion criteria. Association with Vitamin D concentration and composite of 11 cardiac morbidities was done by multivariate (i.e., multiple outcomes per subject) analysis. For other outcomes separate multivariable logistic regressions and adjusting for the potential confounders was used. The observed median vitamin D concentration was 19 [Q1-Q3∶12, 30] ng/mL. Vitamin D concentration was not associated with our primary composite of serious cardiac morbidities (odds ratio [OR], 0.96; 95% CI, 0.86-1.07). Vitamin D concentration was also not associated with any of the secondary outcomes: neurologic morbidity (P = 0.27), surgical (P = 0.26) or systemic infections (P = 0.58), 30-day mortality (P = 0.55), or length of initial intensive care unit (ICU) stay (P = 0.04).
Our analysis suggests that perioperative vitamin D concentration is not associated with clinically important outcomes, likely because the outcomes are overwhelmingly determined by other baseline and surgical factors.
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The deciding point in the study was < 20ng vs > 20 ng.
Vitamin D does not help unless there is enough, say > 30 ng