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Seniors on mechanical ventilation having very low vitamin D died sooner – July 2012

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.

BACKGROUND:
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.

METHODS:
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.

RESULTS:
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.

CONCLUSION:
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.

PMID: 22331959


PDF is attached at the bottom of this page

Death rates for average

  • 12 ng (category < 20) = - - - - - -
  • 25 ng (category >20) = ___

Image

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

Expect that seniors with a good level of vitamin D (say 40-50 ng/ml)

  1. Would been unlikely to have been in the ICU in the first place
  2. Would have gotten out of the ICU alive
      Note: this study excluded patients who were taking vitamin D

See also VitaminDWiki

YearICU 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

Attached files

ID Name Comment Uploaded Size Downloads
1649 ICU ventilation - Sept 2012.pdf PDF admin 12 Oct, 2012 14:23 133.30 Kb 674
1648 ICU ventilation.jpg admin 12 Oct, 2012 14:22 22.60 Kb 866
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