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1.5X increased infection, sepsis, and death if in ICU with low vitamin D - Meta-analysis Dec 2014

Two meta-studies from the same Journal issue are on this page: they agree on mortality

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Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: systematic review and meta-analysis.

Crit Care. 2014 Dec 5;18(6):660. [Epub ahead of print]
de Haan K k.dehaan at erasmusmc.nl , Groeneveld A, de Geus H, Egal M, Struijs A.

VitaminDWiki Summary

ICU with < 20 ng of vitamin D
Infection increased 1.5X
Sepsis increased 1.5X
Death increased 1.8X

Introduction: In Europe, vitamin D deficiency is highly prevalent varying between 40% to 60% in the healthy general adult population. The consequences of vitamin D deficiency for sepsis and outcome in critically ill patients remains controversial. We therefore systematically reviewed observational cohort studies on vitamin D deficiency on the intensive care unit.

Methods: Fourteen observational reports published from January 2000 to March 2014, retrieved from Pubmed and Embase, involving 9,715 critically ill patients and serum 25-hydroxyvitamin D3 (25 (OH)-D) concentrations, were meta-analysed.

Results: Levels of 25 (OH)-D less than 50 nmol/L were associated with increased rates of infection (risk ratio (RR) 1.49, 95% (confidence interval (CI) 1.12 to 1.99), P =0.007), sepsis (RR 1.46, 95% (CI 1.27 to 1.68), P <0.001), 30-day mortality (RR 1.42, 95% (CI 1.00 to 2.02), P =0.05), and in-hospital mortality (RR 1.79, 95% (CI 1.49 to 2.16), P <0.001). In a subgroup analysis of adjusted data including vitamin D deficiency as a risk factor for 30 day-mortality the pooled RR was 1.76 (95% CI 1.37 to 2.26, P <0.001).

Conclusions: This meta-analysis suggests that vitamin D deficiency increases susceptibility for severe infections and mortality of the critically ill.
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PMID: 25475621
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Association between vitamin D deficiency and mortality in critically ill adult patients: a meta-analysis of cohort studies

Critical Care 2014, 18:684 doi:10.1186/s13054-014-0684-9 Published: 12 December 2014
Yan-Peng Zhang1, You-Dong Wan1, Tong-Wen Sun1*, Quan-Cheng Kan2* and Le-Xin Wang3*
Corresponding authors: Tong-Wen Sun suntongwen at 163.com - Quan-Cheng Kan 1017361289 at qq.com - Le-Xin Wang LWang at csu.edu.au
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Abstract (provisional)
Introduction Vitamin D deficiency is common in critically ill patients, and was reported to be associated with adverse outcomes. However, the effect of vitamin D deficiency on mortality in critically ill patients remains unclear.

Methods We searched PubMed and EMBASE from the inception to July 2014 for cohort studies to assess the effect of vitamin D deficiency on the incidence of mortality in critically ill patients. Mortality-specific odds ratio (OR) with 95% confidence interval (CI) were pooled with a random- or fixed-effect models when appropriate.

Results Seven cohort studies with a total of 4,204 participants including 1,679 cases of vitamin D deficiency were included in this meta-analysis.
Vitamin D deficiency was significantly associated with an increased hospital mortality (OR 1.76; 95% CI, 1.38 to 2.24; P <0.001), with very low heterogeneity (I 2?=?2.3%; P =0.402).
The finding of increased hospital mortality in critically ill adult patients was consistently found in every stratum of our subgroup analyses.

Conclusions This meta-analysis suggests that vitamin D deficiency is associated with increased incidence of hospital mortality in critically ill adult patients.
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Attached files

ID Name Comment Uploaded Size Downloads
4718 Zang.jpg admin 12 Dec, 2014 40.55 Kb 930
4717 Critical Care Zang Dec 2014.pdf admin 12 Dec, 2014 734.25 Kb 1019
4695 ICU T1.jpg admin 07 Dec, 2014 133.83 Kb 906
4694 ICU meta-analysis.pdf admin 07 Dec, 2014 858.00 Kb 902