A Zapatero1, I Dot2, Y Diaz2, M P Gracia3, P Pérez-Terán2, C Climent2, J R Masclans4, J Nolla4. 1. Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España; Grupo de Investigación en Patología Crítica (GREPAC), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: 96022@hospitaldelmar.cat. 2. Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España; Grupo de Investigación en Patología Crítica (GREPAC), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España. 3. Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España; Grupo de Investigación en Patología Crítica (GREPAC), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España. 4. Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España; Grupo de Investigación en Patología Crítica (GREPAC), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España; Universitat Pompeu Fabra, Barcelona, España.
Abstract
OBJECTIVES: To evaluate the prevalence of vitamin D deficiency in critically ill patients upon admission to an Intensive Care Unit (ICU) and its prognostic implications. DESIGN: A single-center, prospective observational study was carried out from January to November 2015. Patients were followed-up on until death or hospital discharge. SETTING: The department of Critical Care Medicine of a university hospital. PATIENTS: All adults admitted to the ICU during the study period, without known factors capable of altering serum 25(OH)D concentration. INTERVENTIONS: Determination of serum 25(OH)D levels within the first 24h following admission to the ICU. MAIN VARIABLES OF INTEREST: Prevalence and mortality at 28 days. RESULTS: The study included 135 patients, of which 74% presented deficient serum 25(OH)D levels upon admission to the ICU. Non-survivors showed significantly lower levels than survivors (8.14ng/ml [6.17-11.53] vs. 12ng/ml [7.1-20.30]; P=.04], and the serum 25(OH)D levels were independently associated to mortality (OR 2.86; 95% CI 1.05-7.86; P=.04]. The area under the ROC curve was 0.61 (95% CI 0.51-0.75), and the best cut-off point for predicting mortality was 10.9ng/ml. Patients with serum 25(OH)D<10.9ng/ml also showed higher acute kidney injury rates (13 vs. 29%; P=.02). CONCLUSION: Vitamin D deficiency is highly prevalent upon admission to the ICU. Severe Vitamin D deficiency (25[OH]D<10.9ng/ml) upon admission to the ICU is associated to acute kidney injury and mortality.
OBJECTIVES: To evaluate the prevalence of vitamin D deficiency in critically illpatients upon admission to an Intensive Care Unit (ICU) and its prognostic implications. DESIGN: A single-center, prospective observational study was carried out from January to November 2015. Patients were followed-up on until death or hospital discharge. SETTING: The department of Critical Care Medicine of a university hospital. PATIENTS: All adults admitted to the ICU during the study period, without known factors capable of altering serum 25(OH)D concentration. INTERVENTIONS: Determination of serum 25(OH)D levels within the first 24h following admission to the ICU. MAIN VARIABLES OF INTEREST: Prevalence and mortality at 28 days. RESULTS: The study included 135 patients, of which 74% presented deficient serum 25(OH)D levels upon admission to the ICU. Non-survivors showed significantly lower levels than survivors (8.14ng/ml [6.17-11.53] vs. 12ng/ml [7.1-20.30]; P=.04], and the serum 25(OH)D levels were independently associated to mortality (OR 2.86; 95% CI 1.05-7.86; P=.04]. The area under the ROC curve was 0.61 (95% CI 0.51-0.75), and the best cut-off point for predicting mortality was 10.9ng/ml. Patients with serum 25(OH)D<10.9ng/ml also showed higher acute kidney injury rates (13 vs. 29%; P=.02). CONCLUSION:Vitamin D deficiency is highly prevalent upon admission to the ICU. Severe Vitamin D deficiency (25[OH]D<10.9ng/ml) upon admission to the ICU is associated to acute kidney injury and mortality.
Authors: Agnieszka Rusińska; Paweł Płudowski; Mieczysław Walczak; Maria K Borszewska-Kornacka; Artur Bossowski; Danuta Chlebna-Sokół; Justyna Czech-Kowalska; Anna Dobrzańska; Edward Franek; Ewa Helwich; Teresa Jackowska; Maria A Kalina; Jerzy Konstantynowicz; Janusz Książyk; Andrzej Lewiński; Jacek Łukaszkiewicz; Ewa Marcinowska-Suchowierska; Artur Mazur; Izabela Michałus; Jarosław Peregud-Pogorzelski; Hanna Romanowska; Marek Ruchała; Piotr Socha; Mieczysław Szalecki; Mirosław Wielgoś; Danuta Zwolińska; Arkadiusz Zygmunt Journal: Front Endocrinol (Lausanne) Date: 2018-05-31 Impact factor: 5.555
Authors: Estefania Laviano; Maria Sanchez Rubio; Maria Teresa González-Nicolás; María Pilar Palacian; Javier López; Yolanda Gilaberte; Pilar Calmarza; Antonio Rezusta; Alejandro Serrablo Journal: PLoS One Date: 2020-03-26 Impact factor: 3.240