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Vitamin D and Glutamine resulted in 2.6X reduction in trauma center mortality rate – Dec 2014

VITAMIN D AND GLUTAMINE REDUCE MORTALITY RATE AT A LEVEL I TRAUMA CENTER IN CRITICALLY ILL PATIENTS

Critical Care Medicine: December 2014 - Volume 42 - Issue 12 - p A1623, doi: 10.1097/01.ccm.0000458589.15073.c6
Poster Session: Surgery/Trauma/Burns 7 1092: (Jan 2015 meeting)
Matthews, Leslie1; Ahmed, Yusuf2; Jones, Frank3; Thakkar, Pankti3; Wilson, Kenneth3; Dennis-Griggs, Diane4; Childs, Ed3; Danner, Omar3

VitaminDWiki Summary

6258 patients over 11 year time period

Patients: Category Mortality rate
3285 patients: Standard care10.7%
2973 patients: Vitamin D & Glutamine4.1%


Abstract of poster does not indicate

  1. How much vitamin D or Glutamine was given
  2. How many patients had low levels of vitamin D
  3. The level of vitamin D after treatment

Dr. Matthews reply to question:
98.8% of our patients have vitamin D levels less than 40 ng/ml.
Patients were given vitamin D to get their levels above 40 ng/ml.


Learning Objectives:
Vitamin D levels less than 18ng/ml are associated with a 30% increase in all-cause mortality rate including trauma patients. We hypothesize that vitamin D (a steroid hormone / immune modulator) and glutamine (an essential amino acid during trauma/stress response) supplementation has an appreciable, measurable effect in reducing the hospital mortality rate in critically injured patients.

Methods:
We performed a retrospective study of 6,258 trauma patients listed in the trauma registry at Grady Memorial Hospital, between January 1, 2000 and December 31, 2011. Trauma patients admitted from 2000-2006 (Untreated Group, n=3,285) were treated with standard care. Trauma patients admitted from 2007-2011 (Treated Group, n=2,973) were managed with standard care plus vitamin D/glutamine supplementation. Our primary outcome was mortality rate.

Results:
There were no difference between untreated group and the treated groups in terms of number of admitted patients, gender, age distribution, and trauma type. The mortality rate for untreated group was 10.7% compared to 4.1% of the treated group, a 6.6% absolute reduction in mortality (RRR, 61.6%, 95%CI, 2.26-3.46, P<0.0001).

Conclusions dmplementation of vitamin D and glutamine supplementation significandy reduces the mortality rate, among the trauma patients in the treated group. Further studies are warranted.


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