It is fine do regression analysis on independant variables, but not on dependant variables as this study did
Most of the results of this study, following regression analysis dealth with variables having strong associations to Vitamin D
e.g. smoking, hypertension, race, diabetes, obesity, kidney failure, age, dark skin, etc
Only the portions of the study in the PDF dealing with no regressed data are shown on this page
The study does not appear to define Vitamin D deficiency
I assume that it is 20 ng/ml for all diseases
Note - Some diseases have deficiency levels much higher than 20 ng
Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder—A Nationwide Study
Urvish Patel *, @, Salma Yousuf1,+, Komal Lakhani 2, Payu Raval3,4, Nirmaljot Kaur ®, Toochukwu Okafor 6, Chail Shah 7,8, Harmandeep Singh 5, Mehwish Martin 1, Chika Nwodika 9, Angelina Yogarajah 10, Jigisha Rakholiya 11, Maitree Patel12, Raja Chandra Chakinala 13 and Shamik Shah 14
Download the PDF from VitaminDWiki
Background: According to past studies, recovery and survival following severe vascular events such as acute myocardial infarction and stroke are negatively impacted by vitamin D deficiency. However, the national estimate on disability-related burden is unclear. We intend to evaluate the prevalence and outcomes of vitamin D deficiency (VDD) among patients with cardiovascular disease (CVD) and cerebrovascular disorder (CeVD).
Methods: We performed a cross-sectional study on the Nationwide Inpatient Sample data (2016-2017) of adult (>18 years) hospitalizations. We identified patients with a secondary diagnosis of VDD and a primary diagnosis of CVD and CeVD using the 9th revision of the International Classification of Diseases, clinical modification code (ICD-10-CM) codes. A univariate and mixed-effect multivariable survey logistic regression analysis was performed to evaluate the prevalence, disability, and discharge disposition of patients with CVD and CeVD in the presence of VDD.
Results: Among 58,259,589 USA hospitalizations, 3.44%, 2.15%, 0.06%, 1.28%, 11.49%, 1.71%, 0.38%, 0.23%, and 0.08% had primary admission of IHD, acute MI, angina, AFib, CHF, AIS, TIA, ICeH, and SAH, respectively and 1.82% had VDD.
The prevalence of hospitalizations due to
- CHF (14.66% vs. 11.43%),
- AIS (1.87% vs. 1.71%), and
- TIA (0.4% vs. 0.38%)
was higher among VDD patients as compared with non-VDD patients (p < 0.0001).
In a regression analysis, as compare with non-VDD patients, the VDD patients were associated with higher odds of discharge to non-home facilities with an admission diagnosis of CHF (aOR 1.08, 95% CI 1.07-1.09), IHD (aOR 1.24, 95% CI 1.21-1.28), acute MI (aOR 1.23,95% CI 1.19-1.28), AFib (aOR 1.21,95% CI 1.16-1.27), and TIA (aOR 1.19, 95% CI 1.11-1.28). VDD was associated with higher odds of severe or extreme disability among patients hospitalized with AIS (aOR 1.1,95% CI 1.06-1.14), ICeH (aOR 1.22,95% CI 1.08-1.38), TIA (aOR 1.36, 95% CI 1.25-1.47), IHD (aOR 1.37, 95% CI 1.33-1.41), acute MI (aOR 1.44, 95% CI 1.38-1.49), AFib (aOR 1.10, 95% CI 1.06-1.15), and CHF (aOR 1.03, 95% CI 1.02-1.05) as compared with non-VDD.
Conclusions: CVD and CeVD in the presence of VDD increase the disability and discharge to non-home facilities among USA hospitalizations. Future studies should be planned to evaluate the effect of VDD replacement for improving outcomes.
All statistical analyses were performed using the weighted survey methods in SAS (version 9.4). The p-values of < 0.05 were considered to be significant. The univariate analysis of differences between categorical variables was tested using the Chi-square test, and analysis of differences between continuous variables (age) was tested using paired Student's t-test. Mixed-effects survey logistic regression models with weighted analysis were used to evaluate the effect modification of vitamin D deficiency on estimating outcomes with primary CVD and CeVD. We included demographics (age, gender, race), patient-level hospitalization variables (admission day, primary payer, admission type, median household income category), hospital-level variables (hospital region, teaching vs. non-teaching hospital, hospital bed size), comorbidities (hypertension, diabetes mellitus, obesity, hypercholesterolemia, smoker, and renal dysfunction (end-stage renal disease, and chronic kidney disease)), and Elixhauser comorbidity index. The goodness of fit of the model was evaluated by the c-value.
The prevalence of VDD was higher among
- diabetes mellitus (34.80% vs. 26.38%, p < 0.0001),
- hypertension (69.21% vs. 55.04%, p < 0.0001),
- obesity (24.08% vs. 15.12%, p < 0.0001),
- hyperlipidemia (49.96% vs. 31.65%, p < 0.0001), and
- renal failure (chronic and ESRD) (34.54% vs. 23.66%, p < 0.0001)
as compared with non-VDD
Table 3 shows the univariable outcomes of cardiovascular and cerebrovascular events in VDD. The patients with VDD had a higher prevalence of severe or extreme disability (45.70% vs. 34.79%, p < 0.0001) and discharged non-home (44.25% vs. 28.82%, p < 0.0001) as compared with non-vitamin D deficiency.
The prevalence of severe or extreme disability was higher among VDD patients admitted with
- vascular events (ischemic heart disease (52.92% vs. 38.44%, p < 0.0001),
- acute myocardial ischemia (56.88% vs. 40.29%, p < 0.0001),
- angina (17.59% vs. 11.94%, p < 0.0001),
- atrial fibrillation (40.28% vs. 32.86%, p < 0.0001),
- congestive heart failure (76.08% vs. 72.74%, p < 0.0001),
- acute ischemic stroke (46.54% vs. 40.93%, p < 0.0001),
- transient ischemic attack (27.52% vs. 18.77%, p < 0.0001),
- intracerebral hemorrhage (72.12% vs. 65.03%, p < 0.0001),
- subarachnoid hemorrhage (93.81% vs. 91.07%, p = 0.0346))
as compared with patients without VDD and vascular events.
Vitamin D deficient patients had a higher prevalence of discharged non-home during vascular events (ischemic heart disease (41.74% vs. 31.95%, p < 0.0001), acute myocardial infarction (43.61% vs. 32.81%, p < 0.0001), angina (22.52% vs. 18.58%, p = 0.0182), atrial fibrillation (31.63% vs. 24.17%, p < 0.0001), congestive heart failure (61.72% vs. 58.45%, p < 0.0001), acute ischemic stroke (66.56% vs. 62.32%, p < 0.0001), transient ischemic attack (35.15% vs. 28.99%, p < 0.0001), and intracerebral hemorrhage (81.12% vs. 76.03%, p < 0.0001)) as compared with patients without-VDD and vascular events.