Vitamin D, parathyroid hormone and serum calcium levels and their association with hospital mortality in critically ill patients

Amrein, Karin; Amrein, Steven; Höll, Alexander; Waltensdorfer, Andreas; Pieber, Thomas R.; Dobnig, Harald

doi:10.1186/cc8821

Cited by 8 publications

(6 citation statements)

References 2 publications

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“…Unlike our study their results declared the 28-day mortality in patients with 25(OH)D levels ≤ 10 ng/mL was significantly higher than in patients with 25(OH)D > 10ng/mL, that may be related to their cut-off point (10ng/mL) [19]. Amrein et al demonstrated that critically ill patients with low PTH or serum calcium levels, as well as low 25(OH)D levels (cut-off 12 ng/mL) were all at significantly greater risk for all-cause mortality [20]. Weenink et al measured that 25-hydroxyvitamin D (25-OH-D) on admission and after 48 hours in all consecutive patients admitted to 20-bed general ICU and compared observed and predicted mortality (APACHE IV) their results showed that observed mortality was significantly lower than predicted in all patients and in patients with 25-OH-D > 25 nmol/L, but not in those < 25 nmol/L [21].…”

Section: Resultsmentioning

confidence: 99%

Serum vitamin D level was not associated with severity of ventilator associated pneumonia

Yaghoobi

Taher

Seifrabie

et al. 2019

Romanian Journal of Internal Medicine

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Background and Objective. Vitamin D deficiency is considered one of the most common nutritional deficiencies associated with weakened immune system and increased likelihood of sepsis. The current study was conducted to investigate the association between serum vitamin D level and the severity and prognosis of ventilator associated pneumonia (VAP) in inpatients in intensive care unit (ICU). Methods. Eighty-four consecutive patients with VAP were enrolled in this observational, prospective study conducted in the ICU of Besat Hospital, Hamadan. The patients were examined for serum 25-hydroxyvitamin D (vitD3) level and VAP severity and prognosis. Clinical pulmonary infection score was used for the diagnosis, and Sequential Organ Failure Assessment (SOFA) Score was used to determine the severity of VAP. Results. Low level serum vitD3 (under 30 ng/mL) was found in 66 (78.6%) patients. In this series of VAP patients, there were no significant differences in blood culture results, 14 and 28-day sepsis-associated mortality, mechanical ventilation duration, or SOFA Score on days 3, 7, and 14 between the low level and normal level vitD3 patients (p > 0.05). Conclusion. Serum vitD3 level was not associated with mortality from VAP or complications due to sepsis in the inpatients in the ICU.

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Section: Resultsmentioning

confidence: 99%

Serum vitamin D level was not associated with severity of ventilator associated pneumonia

Yaghoobi

Taher

Seifrabie

et al. 2019

Romanian Journal of Internal Medicine

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“…Vitamin D deficiency is common in critical illness with prevalence between 40 and 70% ( Table 1 ) ( 4 , 5 , 6 , 7 ). In burn patients, the prevalence appears to be even higher ( 8 , 9 ).…”

Section: Vitamin D Status In Critically Ill Patientsmentioning

confidence: 99%

Vitamin D and critical illness: what endocrinology can learn from intensive care and vice versa

Amrein¹,

Papinutti

Mathew

et al. 2018

Endocrine Connections

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The prevalence of vitamin D deficiency in intensive care units ranges typically between 40 and 70%. There are many reasons for being or becoming deficient in the ICU. Hepatic, parathyroid and renal dysfunction additionally increases the risk for developing vitamin D deficiency. Moreover, therapeutic interventions like fluid resuscitation, dialysis, surgery, extracorporeal membrane oxygenation, cardiopulmonary bypass and plasma exchange may significantly reduce vitamin D levels. Many observational studies have consistently shown an association between low vitamin D levels and poor clinical outcomes in critically ill adults and children, including excess mortality and morbidity such as acute kidney injury, acute respiratory failure, duration of mechanical ventilation and sepsis. It is biologically plausible that vitamin D deficiency is an important and modifiable contributor to poor prognosis during and after critical illness. Although vitamin D supplementation is inexpensive, simple and has an excellent safety profile, testing for and treating vitamin D deficiency is currently not routinely performed. Overall, less than 800 patients have been included in RCTs worldwide, but the available data suggest that high-dose vitamin D supplementation could be beneficial. Two large RCTs in Europe and the United States, together aiming to recruit >5000 patients, have started in 2017, and will greatly improve our knowledge in this field. This review aims to summarize current knowledge in this interdisciplinary topic and give an outlook on its highly dynamic future.

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“…Insufficient vitamin D levels could affect this population in various ways [21]. Over the last years, several groups have reported on an inverse association between vitamin D levels in critically ill patients and severity of disease including length of ICU stay and mortality [13,14,16,22,23]. Moreover, vitamin D levels decline further during ICU stay [24] which is explained by insufficient replacement of vitamin D via enteral or parenteral nutrition in the absence of UV-B exposure.…”

Section: Introductionmentioning

confidence: 99%

Correction of vitamin D deficiency in critically ill patients - VITdAL@ICU study protocol of a double-blind, placebo-controlled randomized clinical trial

et al. 2012

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BackgroundVitamin D deficiency is associated with multiple adverse health outcomes including increased morbidity and mortality in the general population and in critically ill patients. However, no randomized controlled trial has evaluated so far whether treatment with sufficiently large doses of vitamin D can improve clinical outcome of patients in an intensive care setting.Methods/designThe VITdAL@ICU trial is an investigator-initiated, non-commercial, double-blind, placebo-controlled randomized clinical trial. This study compares high-dose oral cholecalciferol (vitamin D3) versus placebo treatment in a mixed population of 480 critically ill patients with low 25-hydroxyvitamin-D levels at study enrollment (≤ 20ng/ml). Following an initial loading dose of 540,000 IU of vitamin D3, patients receive 90,000 IU of vitamin D3 on a monthly basis for 5 months. The study is designed to compare clinical outcome in the two study arms with the primary endpoint being length of hospital stay. Secondary endpoints include among others length of ICU stay, the percentage of patients with 25(OH)D levels > 30 ng/ml at day 7, ICU and hospital mortality and duration of mechanical ventilation. We describe here the VITdAL@ICU study protocol for the primary report.DiscussionThis trial is designed to evaluate whether high-dose vitamin D3 is able to improve morbidity and mortality in a mixed population of adult critically ill patients and correct vitamin D deficiency safely.Trial registrationClinicalTrials: NCT01130181

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Vitamin D, parathyroid hormone and serum calcium levels and their association with hospital mortality in critically ill patients

Cited by 8 publications

References 2 publications

Serum vitamin D level was not associated with severity of ventilator associated pneumonia

Serum vitamin D level was not associated with severity of ventilator associated pneumonia

Vitamin D and critical illness: what endocrinology can learn from intensive care and vice versa

Correction of vitamin D deficiency in critically ill patients - VITdAL@ICU study protocol of a double-blind, placebo-controlled randomized clinical trial

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