Low vitamin D at ICU admission is associated with cancer, infections, acute respiratory insufficiency and liver failure – Oct 2018

Nutrition, online 24 October 2018, https://doi.org/10.1016/j.nut.2018.10.018

VitaminDWiki
< 12 ng> 12 ngp (smaller is better)
Cancer 61%31% 0.017
Acute respiratory insufficiency96%63% 0.003
Acute liver failure48%10% 0.002
Infections83%54% 0.034
Died 48%27%0.08

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Trauma and surgery category starts with the following

Trauma and Surgery category has 332 articles

Large dose Vitamin D before surgery was found to help by 35 studies
Vitamin D is needed before most surgeries – many studies and RCTs
4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024
Sepsis is both prevented and treated by Vitamin D - many studies
Thyroidectomy and Vitamin D - many studies
Orthopaedic surgeries need Vitamin D – many studies
Cancer - After diagnosis   chemotherapy
TBI OR "Traumatic Brain Injury - 21 in title as of Sept 2022
Superbug (Clostridium difficile) Infections strongly associated with low vitamin D - many studies
Glutamine and Omega-3 have also been proven to help several traumas/surgeries
   Note: Vitamin D also prevents the need for various surgeries and Omega-3 prevents many concussions/TBI
Trauma and Surgery is associated with 22 other VitaminDWiki categories
  Such as loading dose 33, Mortality 23, Infant-Child 21 Intervention 19 Cardiovascular 13, Injection 13 in Sept 2022

PDF is available free at Sci-Hub  10.1016/j.nut.2018.10.018

Highlights
• 91.6% of ICU patients presented deficiency of serum 25(OH)vitamin D concentrations.
• 25(OH)vitamin D concentrations are strongly associated with prognostic indicators.
• 25(OH)vitamin D concentrations are strongly associated with clinical complications.

Background: Vitamin D deficiency may be associated with comorbidities and poorer prognosis. However, this association in intensive care unit (ICU) patients has not been fully elucidated.

Aim: To investigate whether the serum concentrations of 25-hydroxyvitamin D (25(OH)D) within the first 48 hours after ICU admission are associated with prognostic indicators (APACHE II, SOFA score, Charlson comorbidity index), clinical complications, serum C-reactive protein concentrations, mechanical ventilation duration, and mortality.

Methods: Seventy-one patients were admitted to the ICU, and their concentrations of 25(OH)D in the first 48 hours were analysed. To evaluate the prognostic factors in the ICU, the APACHE II, SOFA score, and Charlson comorbidity index (CCI) questionnaires as well as mechanical ventilation time, CRP and mortality were used.

Results: The mean concentration of 25(OH)D was 17.7 ± 8.27 (range 3.5–37.5) ng/mL, with 91.6% presenting with deficiency at admission. Although no associations were found between serum 25(OH)D concentrations with mechanical ventilation time, CRP, mortality, and APACHE II and SOFA severity scores, we found associations with the CCI when adjusted by age (Model 1: OR=1.64; 95%, 1.14–2.34) and by age, sex and body mass index (BMI) (Model 2: OR=1.59; 95%, 1.10–2.34). In addition, among the comorbidities present, 25(OH)D concentrations were inversely associated with cancer (Crude model OR=3.42; 95%, 1.21–9.64) and liver disease (Crude model OR=9.64; 95%, 2.28–40.60).

Conclusion: We found a strong association between 25(OH)D concentrations and the prognostic indicator CCI and clinical complications (acute respiratory insufficiency, acute liver failure and infections), but no associations with the prognostic indicators APACHE II and SOFA score, CRP, MV duration and mortality. The main comorbidities associated with low 25(OH)D were cancer and liver disease, suggesting that the determination of 25(OH)vitamin D is relevant during the ICU stay.

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