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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2011 Dicembre;77(12):1184-9
Vitamin D deficiency in septic patients at ICU admission is not a mortality predictor
Cecchi A. 1, Bonizzoli M. 1, Douar S. 1, Mangini M. 1, Paladini S. 2, Gazzini B. 1, Degl’Innocenti S. 1, Linden M. 1, Zagli G. 1, Peris A. 1 ✉
1 Anesthesia and Intensive Care Unit, Emergency Department, Careggi Teaching Hospital, Florence, Italy;
2 Nuclear Medicine Department, Careggi Teaching Hospital, Florence, Italy
BACKGROUND:Vitamin D is involved in immune regulation in humans. Vitamin D serum deficiency is reported to be common in hospitalized patients, especially among Intensive Care Unit (ICU) patients. Our aim was to evaluate the relationship between vitamin D levels in septic patients and outcome.
METHODS: A total of 170 patients were studied, of which 92 were severe sepsis/septic shock patients, and 72 were major trauma patients, as an age-matched control group. Exclusion criteria were: age <18 years (y), malnutrition state, pregnancy, breast feeding, chemotherapy, immunotherapy, pathologies affecting bone and calcium metabolism, vitamin D metabolism derangement for therapy, hematological and solid malignancies, and HIV. Vitamin D levels were measured by radioimmunoassay at admission.
RESULTS:Median vitamin D levels at admission to ICU were 10.1 ng/mL in the sepsis group and 18.4 ng/mL in the trauma group (P<0.0001). In univariate analysis, mortality rate in septic patients was significantly correlated with age, gender, SAPS II, vitamin D level at admission, duration of mechanical ventilation, and ICU/hospital length of stay, however, the multivariate logistic regression model confirmed significance only for age.
CONCLUSION: In our cohort, septic patients showed a significantly lower vitamin D level than trauma patients in comparison to age cohort patients with the same demographic/clinical characteristics, but no clear relationship between vitamin D level and outcome was found. Further studies with larger samples are needed to clarify the prognostic role of vitamin D and nutraceutical interventions in critically ill patients.