Heart Attack ICU costs reduced $37,000 by $20 of Vitamin D

Daily, high dose vitamin D supplementation reduces the incidence of myocardial infarctions in surgical intensive care unit patients

Clinical and Experimental Cardiology Conf Texas Nov 30, 2015

L. Ray Matthews, Morehouse School of Medicine, USA

ICU 50,000 IU infarction
rate		 patients with
infarction		 Cost of ICU
if have infarction
Group 1 weekly 7.8% 22 $149,000
Group 2 daily 3.9% 11 $32,000
Note: some surgeons now refuse elective surgery for patients with low vitamin D Surgical outcome is far better if pateints have good levels of vitamin D       Note: a loading dose will provide a good level in about 1 week See also VitaminDWiki * Surgical outcomes are better for higher levels of Vitamin D – systematic review May 2015 * Critically ill need vitamin D – how much and which test to use is TBD – Nov 2014 * ICU death 2X more likely if low vitamin D (sensitivity and selectivity chart) – May 2015 * Shorter time in ICU if have higher level of vitamin D – April 2012 * Traumatic brain injury treated by Vitamin D Progesterone Omega-3 and glutamine – May 2013 Matthews, et al * Vitamin D advocate (Dr. Matthews) is now in Who’s Who Marquis – Feb 2018 * 2X more complications after heart surgery associated with high level of vitamin D – Jan 2013 * Half as many heart deaths for those with high levels of vitamin D – meta-analysis Sept 2012 * Major Heart attacks occur 40 percent more often if vitamin D lower than 7 ng – Feb 2013 * Perhaos the need for heart attack surgery could have been eliminated by having high level of vitamin D * Trauma and surgery **category listing has items along with related searches** In both Intervention AND Trauma/surgery categories {category} Cardiovascular category listing has {include}

Abstract

Often overlooked, are the roles that chronic inflammation/oxidative stress play in the pathogenesis of myocardial infarctions. We hypothesized that vitamin D (a secosteroid hormone with anti-inflammatory capabilities) would reduce the incidence, length of stay, and hospital costs in surgical intensive care unit patients. We performed a prospective study of 565 patients divided into two groups admitted to the surgical intensive care unit at Grady Memorial Hospital between August 2009 and August 2012. Group 1 was treated with vitamin D 50,000 international units weekly. Group 2 was treated with vitamin D 50,000 international units daily.

Primary outcomes were incidence of myocardial infarctions, length of stay, and cost. There were not any statistical differences between the two groups in terms of demographics: age, gender, race, serum albumin, CD4 count, or baseline vitamin D levels.

The number/incidence of myocardial infarctions in Group 1 was 22 (7.8%) and 11 (3.9%) in Group 2 (p value 0.047).

The length of stay for the 22 patients in Group 1 who had a myocardial infarctions was 36.1 days and 8.2 days for the 11 patients in Group 2 (p value 0.007).

The intensive care unit cost for the 22 patients in Group 1 who had a myocardial infarction was $138,991 and $31,549 for the 11 patients in Group 2 (p 0.0005).

Our study demonstrates that vitamin D deficiency is associated with an increased incidence of myocardial infarctions, cost, and length of stay. Further studies are needed to fully assess the impact of vitamin D on cardiovascular health.

Biography

Matthews is a full-time faculty member of Morehouse School of Medicine, Department of Surgery in Atlanta, Georgia, where he serves as Associate Professor of Clinical Surgery. Matthews serves as Director of Surgical Critical Care. He received his medical degree from the University of Mississippi and completed his surgical residency training at Morehouse School of Medicine. He completed a two year surgical critical care fellowship at the Mayo Clinical College of Medicine in Rochester, Minnesota. He is a published author on landmark vitamin D-deficiency manuscripts.

Download the PDF from VitaminDWiki

Cost savings computation by VitaminDWiki

$0.20 per capsule X 10 days X 11 people = $22

ICU costs per 11 people

$69,500 Weekly dosing

$32,000 Daily dosing

Cost savings $37,500 for $22 of Vitamin D