Better Surgical outcomes if preceded by Vitamin D loading dose – Oct 2018

High daily dose of vitamin D linked to fewer heart attacks and lower hospital costs

• The Scientific Forum, Critical Care Surgery, was held October 22 at the 2018 Clinical Congress of the American College of Surgeons in Boston, MA. Program, webcast, and audio information is available online at facs.org/clincon2018.

Vitamin D supplements can brighten the outlook for surgical intensive care patients and their hospitals. Patients who received a high daily dose of vitamin D were less likely to experience a heart attack, had shorter hospital stays and incurred lower costs than patients receiving a lower dose.

Chronic inflammation is known to play a role in the lead-up to heart attacks. Inflammation and vitamin D deficiency sometimes go hand-in-hand, suggesting that the vitamin may act as an anti-inflammatory hormone.

“Vitamin D receptors are found on almost all tissues in the body,” said Golda Kwayisi, MD, Morehouse School of Medicine, Atlanta, GA. “It’s a steroid hormone affecting more than 2,000 genes.”

Yet Vitamin D deficiency is one of the most common nutritional deficiencies in the world. “Most of our patients — approximately 70 percent or more — are vitamin D deficient,” said Dr. Kwayisi.

To investigate this connection, a team led by Leslie Ray Matthews, MD, FACS, Morehouse School of Medicine and Grady Memorial Hospital, Atlanta, GA, looked at how patients who underwent surgical procedures fared after receiving a high daily dose of vitamin D.

Over three years, the team gave all patients who underwent a surgical procedure one of two doses of vitamin D:

• About half of the 565 patients received 50,000 IU of vitamin D per week during their stay, while the other
• half received 50,000 IU of vitamin D per day for one week.

The groups were demographically similar, with no significant differences in terms of gender, age, race, CD4 count or baseline vitamin D levels.

Only 3.9 percent of patients receiving the high dose went on to have heart attacks, compared with 7.8 percent of patients who received the lower dose. Patients receiving the higher dose of the sunshine pill also had shorter stays in the ICU: 7.8 days versus 11.7 days respectively. And these higher dose patients also incurred lower costs: on average $30,093 versus $45,283.

The team recently received the green light for conducting a study that will compare vitamin D treatment with a placebo, which may shed more light on vitamin D’s role in heart health.

Abstract online behind a $39 paywall

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Incidence of Myocardial Infarctions and Hospital Costs in Surgical Intensive Care Unit Patients Reduced by Fifty Percent Using Daily, High Dose Vitamin D Supplementation
Leslie R. Matthews, MD, FACS, Yusuf Ahmed, MD, MPH, Omar K. Danner, MD, FACS, Carolyn Moore, MD, Golda M. Kwayisi, MD, Kahdi F. Udobi, MD, Keren A. Bashan Gilzenrat, MD, Jonathan Nguyen, DO, Peter Rhee, MD, MPH, FACS, Ed W. Childs, MD, FACS
Morehouse School of Medicine, Atlanta, GA; Grady Memorial Hospital, Atlanta, GA
DOI: https://doi.org/10.1016/j.jamcollsurg.2018.08.038

 Download the PDF from Sci-Hub via VitaminDWiki

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