Correlation of Serum Vitamin D Level with Mortality in Patients with Sepsis

Background: Sepsis is the leading cause of mortality in the critically ill. Recently, it has been found in many studies that many trace elements and nutrients do have an effect on human body and if supplemented can improve the prognosis in patients with sepsis. Aim and Objectives: Primary objective: Whether low Vitamin D is associated with mortality. Secondary objective: To find out association of low Vitamin D levels and morbidity in terms of length of hospital and Intensive Care Unit (ICU) stay. Subjects and Methods: Following ethical approval, consent will be sought from either the patient or assent from a near relative. Successive patients admitted to the medical emergency and ICU at tertiary care health center who fulfill the following criteria for sepsis, within a 24 h time window, were included in the study. Results: Among 88 patients evaluated in our study 15 patients (18.2%) were found to have adequate Vitamin D levels and seven patients (8%) were found insufficient and rest 52 patients (73.9%) were found deficient in Vitamin D. Age of the patients ranged between 18 and 82 years with mean (±standard deviation) 45.02 ± 17.69 years. Mean Vitamin D level was found significantly higher among patients with positive outcome than those with unfavorable outcome (expiry) (t = 2.075, P = 0.04). On comparison of the length of hospital stay (morbidity) with Vitamin D levels, we found statistically significant inverse relation between Vitamin D levels and length of hospital stay. Conclusion: Vitamin D deficiency leads to increased risk of mortality in the critically ill along with prolonged hospital stay.

[1]  A. Berghold,et al.  Effect of high-dose vitamin D3 on hospital length of stay in critically ill patients with vitamin D deficiency: the VITdAL-ICU randomized clinical trial. , 2014, JAMA.

[2]  Ajai Pratap Singh,et al.  Incidence of adrenal insufficiency and its relation to mortality in patients with septic shock , 2014 .

[3]  G. Bernard,et al.  Vitamin D deficiency and risk of acute lung injury in severe sepsis and severe trauma: a case-control study , 2014, Annals of Intensive Care.

[4]  Ratender K. Singh,et al.  Prevalence of vitamin D deficiency in critically ill patients and its influence on outcome: experience from a tertiary care centre in North India (an observational study) , 2013, Journal of Intensive Care.

[5]  M. Amer,et al.  Relation between serum 25-hydroxyvitamin D and C-reactive protein in asymptomatic adults (from the continuous National Health and Nutrition Examination Survey 2001 to 2006). , 2012, The American journal of cardiology.

[6]  John H. White Vitamin D metabolism and signaling in the immune system , 2012, Reviews in Endocrine and Metabolic Disorders.

[7]  S. Chilimuri,et al.  Vitamin D deficiency is associated with mortality in the medical intensive care unit , 2011, Critical care.

[8]  G. Martin,et al.  Journal of Translational Medicine BioMed Central Review , 2008 .

[9]  M. Holick,et al.  Vitamin D status: measurement, interpretation, and clinical application. , 2009, Annals of epidemiology.

[10]  D. Bikle Nonclassic actions of vitamin D. , 2009, The Journal of clinical endocrinology and metabolism.