Vitamin D Deficiency in Medical Inpatients: A Retrospective Study of Implications of Untreated Versus Treated Deficiency.
Nutr Metab Insights. 2016 Sep 21;9:65-9. doi: 10.4137/NMI.S33747. eCollection 2016.
Zaidi SA1, Singh G2, Owojori O3, Kela R4, Spoors S5, Abbas M1, Barton F6, Rogers C6.
- “57.4% of the moderate/severe patients had their vitamin D deficiency treated, according to local Trust guidelines.”
- Nothing to indicate who got supplemented other than “Trust guidelines”
- Unlikely that supplementation was random.
- Treatment (100,000 IU monthly for 3 months ) was the same for all ages, weights, skin color, deficiency etc.
- They would have had more decrease in readmission rate if had used
- Higher dose size of Vitamin D for everyone
- Had supplemented for more than 3 months
- Had much higher dose for some - such as Obese
- Had use a different form of Vitamin D for those with poor gut, lacking gall bladder, etc.
See also VitaminDWiki
- Does Less Sun mean More Disease Video by VitaminDWiki includes
75% decrease in patient visits after got Vitamin D higher than 80 nanograms
Dr. who got patients to vitamin D level of 80 ng
- Hospital costs higher if lower vitamin D
- Seniors need at least 4,000 IU vitamin D, no test needed – Consensus Jan 2014
4,000 IU daily = 120,000 IU per month - forever, not just 3 months
- UK would save as least 636 million dollars annually by giving 800 IU vitamin D free to all seniors – June 2014 -800 IU daily = 24,000 IU per month
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Falls cut in half by 100,000 IU vitamin D monthly - RCT 2016 - for much longer than 3 months
Many of the inpatients in the study on this page were in the hospital because of falls
- Vitamin D once during pregnancy reduced infant health care costs (300 times ROI) – RCT Dec 2015
- 18 fewer hospital days if given 500,000 IU of vitamin D while ventilated in ICU – RCT June 2016
- Vitamin D supplementation of all pregnant women (in UK) would be cost effective – just considering pre-eclampsia – March 2016
- Heart Attack ICU costs reduced $37,000 by $20 of Vitamin D – Nov 2015
Vitamin D deficiency and insufficiency may further increase fracture risk in patients with decreased bone mineral density. A cross-sectional study on serum vitamin D concentrations in medical inpatients was conducted at Bassetlaw District General Hospital between April 2014 and January 2015 (10 months), and the relationship of serum vitamin D concentrations with calcium and alkaline phosphatase was evaluated. 25-Hydroxyvitamin D immunoassays were used and analyzed in the local laboratory. The total number of patients analyzed was 200, age range 18-99 years, with mean age of 76 years. The most common presentation was found to be fall/collapse. The following cutoff points for serum vitamin D were used: levels =30 nmol/L for severe deficiency, >30-50 nmol/L for moderate deficiency, >50-75 nmol/L for mild deficiency, and anything above 75 nmol/L as normal. Of the 209 participants examined, 78 (37.3%) participants had mild vitamin D deficiency, 54 (25.8%) participants had moderate vitamin D deficiency, 68 (32.5%) participants had severe vitamin D deficiency, and 9 (4.3%) participants with low vitamin D levels died during their admission.
Of the 122 moderate/severe patients, 70 (57.4%) patients had their vitamin D deficiency treated, according to local Trust guidelines. The study found no relationship between serum calcium levels and vitamin D deficiency, whereas patients' alkaline phosphatase levels were found to be higher with increased severity of vitamin D deficiency. The study examined the implications of untreated severe/moderate vitamin D deficiency compared to treated deficiency, in terms of the frequency of readmission with similar complaints.
It was found that the rate of readmission within one year in patients who were not treated was 57%, compared to 48% in patients whose vitamin D deficiency was treated. Presenting after falls was a recurring theme. It was concluded that even if moderate vitamin D deficiency can be asymptomatic, it is important to correct it as it can have an impact on morbidity and readmission rates in the long term.
PMID: 27688711 DOI: 10.4137/NMI.S33747