Does vitamin D administration play a role in outcome of patients with acute ischemic stroke? A randomized controlled trial

Rezaei, Omidvar; Ramezani, Mahtab; Roozbeh, Mehrdad; Fazeli, Bahareh; Hajiesmaeili, Mohammadreza; Pakdaman, Hossein; Simani, Leila

doi:10.18502/cjn.v20i1.6374

Cited by 4 publications

(14 citation statements)

References 26 publications

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“…Pada studi ini, didapatkan bahwa 7 artikel studi yang digunakan dalam evidence based case study ini menggunakan desain uji terkontrol acak atau randomized controlled trials (RCT) (Gupta et al, 2016;Hesami et al, 2022;Kadri et al, 2020;Karasu & Karataş, 2021;Narasimhan & Balasubramanian, 2017;Rezaei et al, 2021;Torrisi et al, 2021). Usia pasien yang terlibat dalam studi penelitian yang disertakan berkisar antara 18-80 tahun.…”

Section: Results Desain Dan Karakteristik Studiunclassified

“…Usia pasien yang terlibat dalam studi penelitian yang disertakan berkisar antara 18-80 tahun. Tipe diagnose medis stroke yang dimiliki oleh responden dalam studi penelitian yang disertakan yaitu sebanyak 5 studi hanya menyertakan pasien stroke iskemik sebagai responden penelitian (Gupta et al, 2016;Hesami et al, 2022;Kadri et al, 2020;Narasimhan & Balasubramanian, 2017;Rezaei et al, 2021) dan sebanyak 2 studi melibatkan pasien stroke iskemik dan hemoragik (Karasu & Karataş, 2021;Torrisi et al, 2021).…”

Section: Results Desain Dan Karakteristik Studiunclassified

“…Sebanyak 5 studi yang disertakan hanya meneliti tentang efektivitas pemberian terapi vitamin D (Hesami et al, 2022;Karasu & Karataş, 2021;Narasimhan & Balasubramanian, 2017;Rezaei et al, 2021;Torrisi et al, 2021), satu studi mengenai kombinasi pemberian vitamin D dan A pada pasien stroke (Kadri et al, 2020) dan satu studi menguji efektifitas kombinasi pemberian vitamin D dan kalsium (Gupta et al, 2016). Sebanyak 5 studi meneliti tentang efektivitas pemberian vitamin D selama perawatan stroke akut (Gupta et al, 2016;Hesami et al, 2022;Kadri et al, 2020;Narasimhan & Balasubramanian, 2017;Rezaei et al, 2021) dan 3 studi lainnya pada kondisi pasca stroke (Karasu & Karataş, 2021;Narasimhan & Balasubramanian, 2017;Torrisi et al, 2021).…”

Section: Results Desain Dan Karakteristik Studiunclassified

“…Dosis vitamin D yang diberikan pada pasien stroke yang menjadi responden penelitian didapatkan bahwa sebanyak 2 studi memberikan vitamin D dalam bentuk sediaan kapsul dengan dosis 50.000 IU per minggu atau sebanyak dosis tunggal vitamin D 300.000 IU secara intra muscular (IM) (Karasu & Karataş, 2021;Rezaei et al, 2021), sebanyak 2 studi memberikan dosis sebesar 600.000 IU secara IM per bulan (Hesami et al, 2022;Narasimhan & Balasubramanian, 2017), satu studi memberikan vitamin D 2000 IU secara oral per hari (Torrisi et al, 2021), satu studi memberikan kombinasi pemberian vitamin D dengan kalsium yaitu 600.000 IU cholecalciferol diikuti dengan cholecalciferol oral 60.000 IU sebulan sekali dengan satu gram unsur kalsium setiap hari (Gupta et al, 2016) serta satu studi memberikan pemberian vitamin D 50.000 IU per kapsul dikombinasikan dengan vitamin A sebesar 50.000 IU seminggu sekali (Kadri et al, 2020).…”

Section: Results Desain Dan Karakteristik Studiunclassified

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Efektivitas Pemberian Vitamin D Selama Masa Perawatan Pada Pasien Stroke

Wijanadi,

Harimawan

2023

JKU

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Pendahuluan dan tujuan: Pemberian vitamin D pada pasien stroke telah dikaitkan dengan adanya perbaikan status fungsional yang lebih baik karena membantu memodifikasi berbagai faktor risiko kardiovaskular. Studi ini disusun untuk mengetahui efektifitas dari pemberian suplemen vitamin D pada pasien stroke. Metode: Studi ini menggunakan pendekatan evidence based case study yang dilakukan pada Juli 2023 dengan menyertakan ilustrasi kasus beserta beberapa studi penelitian pendukung untuk memperkuat hasil temuan. Pencarian studi dikumpulkan melalui PubMed, Proquest dan ScienceDirect berdasarkan PICO framework. Hasil: Sebanyak tujuh studi disertakan untuk mendukung penarikan simpulan ilustrasi kasus terkait efektifitas pemberian vitamin D. Hasil studi menunjukkan adanya variasi efek dari pemberian dosis tunggal vitamin D maupun dengan kombinasi unsur nutrisi lainnya mencakup membantu menurunkan kadar serum interleukin-1β (IL-1β) dan interleukin 6 (IL-6), meningkatkan fungsi neurologis pasien, mencegah hiperparatiroidisme sekunder. Efek positif dari adanya pemberian vitamin D juga terlihat selama masa rehabilitasi pasien stroke meliputi pada perbaikan regulasi mood dan pemulihan fungsional serta peningkatan fungsi motorik ekstremitas bawah dan ambulasi. Simpulan: Pemberian vitamin D pada pasien stroke memberikan kontribusi positif pada fase akut maupun rehabilitasi melalui berbagai mekanisme fisiologi tubuh. Profesional kesehatan diharapkan dapat mempertimbangkan pemberian vitamin D ke dalam rencana perawatan nutrisi pasien untuk mencapai hasil status kesehatan yang optimal.

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Section: Results Desain Dan Karakteristik Studiunclassified

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Efektivitas Pemberian Vitamin D Selama Masa Perawatan Pada Pasien Stroke

Wijanadi,

Harimawan

2023

JKU

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“…The use of IM injection of single high-dose vitamin D in patients with ischemic stroke can be an appropriate treatment option in patients with poor compliance to daily oral vitamin D supplementation and could increase serum 25-OH vitamin D level rapidly and safely [ 16 ]. A few studies have examined the effect of high doses of vitamin D on the stroke severity and functional outcome scales of patients with ischemic stroke [ 17 , 18 , 31 ]. In accordance with our findings, Narasimhan et al and Sari et al revealed that a single dose, IM injection of 300000 to 600000 IU of vitamin D could improve functional outcomes of patients with ischemic stroke including Scandinavian Stroke Scale (SSS), mRS, NIHSS, and BI besides their balance [ 17 , 18 ], whereas Rezaei et al showed a single dose of 300000 IU IM vitamin D had no favorable effects on NIHSS score [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of the Neuroprotective Effect of a Single High-Dose Vitamin D3 in Patients with Moderate Ischemic Stroke

Hesami

Iranshahi

Shahamati

et al. 2022

Stroke Research and Treatment

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Introduction. Vitamin D insufficiency is highly prevalent and is a negative predictor for survival in ischemic stroke patients. We evaluated the effect of a high dose of vitamin D3 on the Neuron-Specific Enolase (NSE) level, National Institute of Health Stroke Scale (NIHSS), and Barthel Index (BI) scoring system in moderate ischemic stroke patients. Methods. This prospective, double-blind, randomized clinical trial (RCT) study was conducted from April 2020 to March 2021. Patients with moderate ischemic stroke (NIHSS 5 to 15) who had vitamin D deficiency (serum 25-OH vitamin D ≤30 ng/mL) were recruited and randomized into intervention and control groups. Subjects in the intervention group received a single dose, intramuscular (IM) injection of 600000 international unit (IU) vitamin D3, in addition to the standard treatment. NSE level and NIHSS were evaluated at baseline and 48 hours after the intervention. The BI was monitored three months after discharge. Results. During the study period, 570 patients were assessed; finally, forty-one patients completed the study. Except for the age which was higher in the control group ( p = 0.04 ), there were no statistically significant differences in other baseline characteristics between the two groups. After 48 hours, the NIHSS score was significantly lower in the intervention group (median 8 vs. 6.5, p = 0.008 in the control and intervention groups, respectively), but there was no significant difference in the NSE level ( p = 0.80 ). Three months after discharge, the BI was significantly higher in the intervention group (median 8 vs. 9, p = 0.03 in the control and intervention groups, respectively). Conclusions. Administration of a single 600000 IU of vitamin D3 could have neuroprotective effects in patients with moderate ischemic stroke, according to its significantly positive effects on functional clinical outcomes (NIHSS and BI), but this effect on the biomarker related to neural damage (NSE) was not significant.

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Relationship between Vitamin D Status in Acute Ischemic Stroke for Assessing Initial Severity and Short-Term Outcome in a Tertiary Level Hospital, Bangladesh

Rahman

Ahmed

Russel

et al. 2023

J. of Sci. and Tech. Res.

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Recent studies suggest that vitamin D, a neuroprotective prohormone, which has a potential protective role against neurovascular injury. Low vitamin D levels were modestly associated with risk of stroke and stroke fatality. Objective: This study aimed to investigate the relationship of vitamin D status among acute ischemic stroke patients for assessing initial severity and short-term outcome. Methods: Fifty one acute ischemic stroke patients and 51 matched healthy control subjects participated in the study. Subjects were divided according to vitamin D level into deficient, insufficient, and sufficient groups. National Institute of Health Stroke Scale (NIHSS) on admission and after 72h and modified Rankin Scale (mRS) on discharge and after 3months were performed for all patients. Results: Acute ischaemic stroke patients (9.8%) had significantly lower serum vitamin D levels compared to healthy subjects (5.8%). In patients, serum vitamin D level ranged from 5 to 41ng/ml with a mean of 19.4±9.98ng/ml. In controls, serum vitamin D levels ranged from 6 to 48ng/ml with a mean of 30.3±10.48 ng/ml. Vitamin D deficiency and insufficiency were significantly prevalent among stroke patients (66.7%) compared to healthy controls (51.9%). Significant correlation was detected between serum vitamin D and NIHSS scores on admission and after 72hrs (p=0.007). Significant correlation was also detected between serum vitamin D and mRS scores on discharge and after 3months (p=0.004). The patients with 'not sufficient' vitamin D (i.e. deficient and insufficient) were 11.2 time more likely to report severe stroke (p=0.006). Conclusion: Vitamin D deficiency increases the risk of acute ischemic stroke and is associated with increased initial stroke severity and worse short-term outcome. J. of Sci. and Tech. Res. 4(1): 119-128, 2022

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Does vitamin D administration play a role in outcome of patients with acute ischemic stroke? A randomized controlled trial

Cited by 4 publications

References 26 publications

Efektivitas Pemberian Vitamin D Selama Masa Perawatan Pada Pasien Stroke

Efektivitas Pemberian Vitamin D Selama Masa Perawatan Pada Pasien Stroke

The Evaluation of the Neuroprotective Effect of a Single High-Dose Vitamin D3 in Patients with Moderate Ischemic Stroke

Relationship between Vitamin D Status in Acute Ischemic Stroke for Assessing Initial Severity and Short-Term Outcome in a Tertiary Level Hospital, Bangladesh

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