Prevalence and association of vitamin D deficiency and mortality in patients with severe sepsis
Authors Trongtrakul K, Feemuchang C
Received 2 August 2017
Accepted for publication 10 October 2017
Published 8 November 2017 Volume 2017:10 Pages 415—421
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Konlawij Trongtrakul,1 Chookiat Feemuchang2
1Critical Care Division, Emergency Medicine Department, 2Internal Medicine Department, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Background: Vitamin D is a steroid prohormone that regulates body calcium and phosphate metabolism. Recent studies have shown an association between low vitamin D status and high mortality in patients admitted to intensive care units. To date, there are limited data available specifically about severely septic patients in medical units.
Objectives: To determine the prevalence of vitamin D deficiency in severely septic patients and its clinical outcomes, including mortality rate.
Methods: A prospective observational study was conducted to investigate the prevalence of vitamin D deficiency and its association with 30-day mortality in patients with severe sepsis. Patients admitted to medical wards at our hospital between November 2014 and March 2015 were included in the study. A 25-hydroxyvitamin D level <20 ng/mL was defined as vitamin D deficiency, and <12 ng/mL as severe deficiency. For an association analysis, the patients were grouped into deficient versus not deficient and severely deficient versus not severely deficient.
Results: One hundred and ten eligible patients were enrolled. A total of 83 patients (75%) had vitamin D deficiency and 42 (38%) had severe deficiency. Despite an insignificant higher 30-day hospital mortality rate in vitamin D deficient versus non-deficient groups (16% vs 4%, p=0.18), the differences were significant between the severely deficient versus non-severe groups (23% vs 4%, p=0.02). The odds ratio of the 30-day mortality rate was 4.83 (95% confidence interval [CI], 0.60–38.77, p=0.14) for vitamin D deficiency and 7.69 (95% CI, 2.00–29.55, p=0.003) for severe deficiency.
Conclusion: The prevalence of vitamin D deficiency was very high in three-quarters of patients with severe sepsis. A significant higher mortality rate was observed, particularly in patients with severe vitamin D deficiency.
Keywords: vitamin D deficiency, 25-hydroxyvitamin D, severe sepsis, medical unit, mortality rate
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