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Chance of death after non-cardiac surgery reduced 2X by Vitamin D – Aug 2014

The Association of Serum Vitamin D Concentration with Serious Complications After Noncardiac Surgery.

Anesth Analg. 2014 Aug 13. [Epub ahead of print]
Turan A1, Hesler BD, You J, Saager L, Grady M, Komatsu R, Kurz A, Sessler DI.
1From the Departments of *Outcomes Research, †Quantitative Health Sciences and Outcomes Research, and ‡Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.

VitaminDWiki Summary

7% less likely to die for every extra 5 ng of vitamin D

Odds ratio for deathVitamin D level
1.0 < 13 ng
0.65 13-20 ng
0.53 20-27 ng
0.44 27-36 ng
0.49 > 36 ng

Vitamin D deficiency is a global health problem. Epidemiological studies demonstrate that vitamin D is both cardioprotective and neuroprotective. Vitamin D also plays a substantial role in innate and acquired immunity. Our goal was to evaluate the association of serum vitamin D concentration on serious postoperative complications and death in noncardiac surgical patients.
We retrospectively analyzed the data of 3509 patients who had noncardiac surgery at the Cleveland Clinic Main Campus and had a serum vitamin D measurement. The relationship between serum vitamin D concentration and all-cause in-hospital mortality, in-hospital cardiovascular morbidity, and serious in-hospital infections was assessed as a common effect odds ratio (OR) by using a multivariate generalized estimating equation model with adjustment for demographic, medical history variables, and type and duration of surgery.
Higher vitamin D concentrations were associated with decreased odds of in-hospital mortality/morbidity (P = 0.003). There was a linear reduction of the corresponding common effect odds ratio (OR 0.93, 95% confidence interval, 0.88-0.97) for severe in-hospital outcomes for each 5 ng/mL increase in vitamin D concentration over the range from 4 to 44 ng/mL. In addition, we found that the odds versus patients with vitamin D <13 ng/mL (i.e., 1st quintile) were significantly lower in patients with vitamin D 13-20, 20-27, 27-36, and > 36 ng/mL (i.e., 2nd-5th quintiles); the corresponding estimated ORs were 0.65 (99% confidence interval, 0.43-0.98), 0.53 (0.35-0.80), 0.44 (0.28-0.70), and 0.49 (0.31-0.78), respectively. However, there was no statistically significant difference among individual quintiles >13 ng/mL.
Vitamin D concentrations were associated with a composite of in-hospital death, serious infections, and serious cardiovascular events in patients recovering from noncardiac surgery. While causality cannot be determined from our retrospective analysis, the association suggests that a large randomized trial of preoperative vitamin D supplementation and postoperative outcomes is warranted.

PMID: 25121616

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