Seniors on mechanical ventilation having very low vitamin D died sooner

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@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 (P?PDF is attached at the bottom of this page

Death rates for average

• 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

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

• All items Breathing and Vitamin D items

• 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 items

• 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