Clinical scienceWorsening severity of vitamin D deficiency is associated with increased length of stay, surgical intensive care unit cost, and mortality rate in surgical intensive care unit patients
Section snippets
Methods
We conducted a prospective observational study on the vitamin D status of 258 trauma, vascular, and general surgery patients admitted to the surgical intensive care unit at Grady Memorial Hospital between August 2009 and January 2011 to assess the prevalence of vitamin D deficiency and its impact on adverse outcomes in this patient population. The research protocol was approved by the Morehouse School of Medicine's Institutional Review Board. All patients admitted to the surgical intensive care
Results
Of the 258 patients evaluated, 70.2% (181) were men, and 29.8% (77) were women; 57.6% (148) were African American and 32.4% (109) were Caucasian. A total of 138 (53.5%) of the patients had severe vitamin D deficiency, 99 (38.4%) had moderate deficiency, 18 (6.9%) had mild deficiency, and 3 (1.2%) of the patients had normal vitamin D levels. Eighty percent (206) were trauma patients, 20.2% (52) developed pneumonia during the intensive care unit (ICU) stay, and 40.0% (85) of the patients were
Discussion
Vitamin D deficiency has been found to be very prevalent in modern society.1 Association between vitamin D deficiency and increased mortality in the general population is now fairly well established.5, 8, 9, 10 According to many experts, normal vitamin D status seems to reduce the risk of almost every chronic disease of aging.6, 7, 12, 13 In fact, a recent study showed that people with deficient vitamin D levels were twice as likely to die over a 7-year period as individuals with a normal serum
Conclusions
Moderate to severe vitamin D deficiency increases length of stay in surgical intensive care unit patients, ICU treatment cost, and mortality rate. Therefore, vitamin D status should be screened in all surgical intensive care unit patients at admission, and potentially treated even when a serum level of less than 40 ng/mL is identified. Further study is needed to determine the optimal treatment for this potential risk factor in surgical intensive care unit patients.
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