Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients.
QJM. 2012 Jul;105(7):633-9. doi: 10.1093/qjmed/hcs014. Epub 2012 Feb 12.
Arnson Y, Gringauz I, Itzhaky D, Amital H. hamital at netvision.net.il
Department of Medicine B, Sheba Medical Center, Tel-Hashomer 52621, Israel.
Vitamin D plays a seminal role in many homeostatic mechanisms.
In this study, we assessed the correlation between circulating vitamin D levels and mortality rates in critically ill patients.
All patients admitted to the intensive care units (ICUs) and internal medicine wards in a university-based hospital that required mechanical ventilation were admitted. Data collected included the underlying disease, basic hematological and biochemical blood test results, APACHE II scores and serum 25-hydroxyvitamin D [25(OH)D] levels. The primary end point was defined as all-cause mortality within 60 days from admission or from acute deterioration.
Between December 2008 and June 2009, 130 patients were enrolled. Average vitamin D concentration was 14.04?±?6.9?ng/ml; 107 patients were vitamin D deficient (<?20?ng/ml). Total mortality rate after 60 days was 44.3%. Vitamin D levels were correlated with white blood cell (WBC) count, but with no other measured variable. Among the deceased patients, survival curves indicated that survival of patients with vitamin D deficiency was significantly shorter than those whose vitamin D concentration was >20?ng/ml (P?<?0.05); the average survival time was 15.3?±?12.4 days for vitamin D deficient patients compared with 24.2?±?16.5 days among those with normal vitamin D levels.
This study demonstrated that low vitamin D levels are common among patients admitted to ICU.
We observed longer survival times among vitamin D sufficient patients. Our results indicate that vitamin D concentration may be either a biomarker of survival or a co-factor.
We recommend assessing the effects of vitamin D supplementation in critically ill patients.
PDF is attached at the bottom of this page
- 12 ng (category < 20) = - - - - - -
- 25 ng (category >20) = ___
Strange: paper states overall mortality rate of 44% within 60 days of hospitalization for all patients.
Yet the graph seems to indicate 100% death rate within 60 days
- Would been unlikely to have been in the ICU in the first place
- Would have gotten out of the ICU alive
Note: this study excluded patients who were taking vitamin D
- All items Breathing and Vitamin D
- COPD and vitamin D in a vicious circle – April 2011
- One third of lung disease patients in China had less than 4ng of vitamin D – May 2012
- Vitamin D and the Lung – professional book 2012
- COPD patients 4X more likely to have low Vitamin D – 2 articles in 2012
- Vitamin D deficiency is highly prevalent in COPD - 2010
- 100 % of Acute Respiratory Failure patients had low vitamin D - April 2012
- Hypothesis: Respiratory problems will decrease with increased vitamin D – Jan 2012
- Lung and Vitamin D – Special Issue Dec 2011
- 5 days longer in ICU if low on vitamin D - April 2012
- Only 200 IU vitamin D in intravenous feeding of multivitamins – Aug 2012
- All items in category After Surgery or Trauma
- Vitamin D's potential to reduce the risk of hospital-acquired infections – May 2012
- All mentions of Amital H in VitaminDWiki 35 as of Oct 2012
- Hospital stay 6 days longer for nursing home residents with low vitamin D – Oct 2011
- ICU needs vitamin D - Vitamin D Council Sept 2011
- ICU time is 2X more likely to be longer than 2 days if vitamin D less than 20 ng – Mar 2011
- Study: 540,000 IU oral to ten patients near death in an ICU as a single dose achieved around 40 ng/ml, but it takes three days to do so
- "I predict that eventually vitamin D will be available as an IV and that the most useful preparation will be intravenous 25(OH)D."
- Virtually all veterans in ICU had vitamin D less than 32 ng – Jan 2011
- Critical Care patients need vitamin D
- Longer mechanical ventilation times in ICU if lower vitamin D levels – Jan 2015
Summary of studies of ICU and Vitamin D levels as of Jan 2012
Year ICU problem If vitamin D less than 2011 this page 85 % increased death 20 ng 2011 85 % increased death 15 ng 2011 70 % increased death 15ng 2011 2X more likely to stay 2 days 20 ng