ICU time is 2X more likely to be longer than 2 days if vitamin D less than 20 ng – Mar 2011

Relationship between vitamin d status and ICU outcomes in veterans.

J Am Med Dir Assoc. 2011 Mar;12(3):208-11.
McKinney JD, Bailey BA, Garrett LH, Peiris P, Manning T, Peiris AN.
Mountain Home VAMC, Mountain Home, TN; ETSU Department of Internal Medicine, Johnson City, TN.

OBJECTIVE: Vitamin D deficiency remains a poorly recognized pandemic and is closely linked to increased health care costs in veterans. Projected health care needs in veterans are expected to increase over the next decade. Intensive care unit (ICU) costs contribute significantly to hospital costs and stem from intervention services and management of sepsis including nosocomial infections. Vitamin D has immunomodulating and antimicrobial properties through antimicrobial peptides such as cathelicidin.

DESIGN/METHODS: A retrospective study was undertaken to evaluate if vitamin D deficiency was associated with less than optimal ICU outcomes in veterans.
The study included 136 veterans with 25(OH)D levels drawn within a month of admission to ICU.

RESULTS: The average 25(OH)D level was 24.6 ng/mL (normal range 30-100) with 38% of patients falling in the vitamin D-deficient category (<20 ng/mL).
ICU survivors had a significantly lower rate of vitamin D deficiency compared with nonsurvivors (28% versus 53%).

Twenty-nine percent of vitamin D-replete patients were in ICU 3 days or more, whereas 58% of patients with vitamin D deficiency stayed in ICU 3 days or longer.

This difference was highly significant translating to twofold increased risk
(2.0 Relative Risk [RR]) for 3-day or longer stay in ICU for patients with vitamin D deficiency.
Moreover, the risk of death was significantly higher in ICU patients with vitamin D deficiency (RR 1.81).

CONCLUSION: A vitamin D-replete state may reduce costs and confer survival advantages in critical illness.
We recommend that 25(OH)D levels be routinely checked and deficiencies treated in ICU patients.

Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved. PMID: 21333923

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See also VitaminDWiki

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• Health Care Providers save $ by providing vitamin D before and/or after surgery or trauma - reduces the time in bed, etc.
• Virtually all veterans in ICU had vitamin D less than 32 ng – Jan 2011
• 540,000 IU before ICU raised vitamin D level average at least 25 ng – March 2011
• Vitamin D prescriptions in US Military increased 5X in 5 years – July 2015