Prevalence of Vitamin D Deficiency and Associated Factors in Critically Ill Patients: A Multicenter Observational Study

Frontiers in Nutrition

Sheng-Yuan Ruan¹  Yin-Yi Han²  Li-Kuo Kuo³  Yin-Chin Wang⁴  Anne Chao⁴  Yu-Ting Kuo⁴  Ching-Tang Chiu⁴  Yu-Chang Yeh⁴  Kuo-Ching Yuan⁵  Yi-Che Lin⁷  Ming-Chieh Shih⁸  Kuo-Wei Chen⁹  Fang-Ming Hung^1,10  Chung-Wei Chen^1,10  I-Ting Wang^1,11  Yu-Chung Kung^1,11  An-Yi Wang^1,12 

[1] 0Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan;1Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan;2Department of Medicine, Mackay Medical College, New Taipei City, Taiwan;Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan;Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan;Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei, Taiwan;Department of Environment and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan;Department of Public Health, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan;Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan;Department of Surgical Intensive Care Unit, Far Eastern Memorial Hospital, New Taipei City, Taiwan;Division of Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan;Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan;

关键词: vitamin D;    critical care;    deficiency;    severity;    mortality;   

DOI  :  10.3389/fnut.2021.768804

来源: DOAJ

【 摘 要 】

Background: Vitamin D deficiency is common in the general population worldwide, and the prevalence and severity of vitamin D deficiency increase in critically ill patients. The prevalence of vitamin D deficiency in a community-based cohort in Northern Taiwan was 22.4%. This multicenter cohort study investigated the prevalence of vitamin D deficiency and associated factors in critically ill patients in Northern Taiwan.Methods: Critically ill patients were enrolled and divided into five groups according to their length of stay at intensive care units (ICUs) during enrolment as follows: group 1, <2 days with expected short ICU stay; group 2, <2 days with expected long ICU stay; group 3, 3-7 days; group 4, 8-14 days; and group 5, 15-28 days. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) level < 20 ng/ml, and severe vitamin D deficiency was defined as a 25(OH)D level < 12 ng/ml. The primary analysis was the prevalence of vitamin D deficiency. The exploratory analyses were serial follow-up vitamin D levels in group 2, associated factors for vitamin D deficiency, and the effect of vitamin D deficiency on clinical outcomes in critically ill patients.Results: The prevalence of vitamin D deficiency was 59% [95% confidence interval (CI) 55-62%], and the prevalence of severe vitamin D deficiency was 18% (95% CI 15-21%). The median vitamin D level for all enrolled critically ill patients was 18.3 (13.7-23.9) ng/ml. In group 2, the median vitamin D levels were <20 ng/ml during the serial follow-up. According to the multivariable analysis, young age, female gender, low albumin level, high parathyroid hormone (PTH) level, and high sequential organ failure assessment (SOFA) score were significantly associated risk factors for vitamin D deficiency. Patients with vitamin D deficiency had longer ventilator use duration and length of ICU stay. However, the 28- and 90-day mortality rate were not associated with vitamin D deficiency.Conclusions: This study demonstrated that the prevalence of vitamin D deficiency is high in critically ill patients. Age, gender, albumin level, PTH level, and SOFA score were significantly associated with vitamin D deficiency in these patients.

【 授权许可】

Unknown