You are here

  • Home
  • Archive
  • Volume 2, Issue 1
  • Association between prehospital vitamin D status and incident acute respiratory failure in critically ill patients: a retrospective cohort study

Article Text

Article menu

Download PDFPDF

XML
Critical care
Association between prehospital vitamin D status and incident acute respiratory failure in critically ill patients: a retrospective cohort study
  1. David R Thickett1,
  2. Takuhiro Moromizato2,
  3. Augusto A Litonjua3,
  4. Karin Amrein4,
  5. Sadeq A Quraishi5,
  6. Kathleen A Lee-Sarwar6,
  7. Kris M Mogensen7,
  8. Steven W Purtle8,
  9. Fiona K Gibbons9,
  10. Carlos A Camargo Jr10,
  11. Edward Giovannucci11 and
  12. Kenneth B Christopher12
  1. 1School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  2. 2Department of Medicine, Hokubu Prefectural Hospital, Nago City, Japan
  3. 3Channing Division of Network Medicine and Pulmonary and Critical Care Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  4. 4Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
  5. 5Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  6. 6Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  7. 7Department of Nutrition, Brigham and Women's Hospital, Boston, Massachusetts, USA
  8. 8Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Denver, Colorado, USA
  9. 9Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  10. 10Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  11. 11Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
  12. 12The Nathan E. Hellman Memorial Laboratory, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Kenneth B Christopher; kbchristopher{at}partners.org

Abstract

Objective We hypothesise that low 25-hydroxyvitamin D (25(OH)D) levels before hospitalisation are associated with increased risk of acute respiratory failure.

Design Retrospective cohort study.

Setting Medical and Surgical Intensive care units of two Boston teaching hospitals.

Patients 1985 critically ill adults admitted between 1998 and 2011.

Interventions None.

Measurements and main results The exposure of interest was prehospital serum 25(OH)D categorised as ≤10 ng/mL, 11–19.9 ng/mL, 20–29.9 ng/mL and ≥30 ng/mL. The primary outcome was acute respiratory failure excluding congestive heart failure determined by International Classification of Diseases Ninth Edition (ICD-9) coding and validated against the Berlin Definition of acute respiratory sistress syndrome. Association between 25(OH)D and acute respiratory failure was assessed using logistic regression, while adjusting for age, race, sex, Deyo-Charlson Index and patient type (medical vs surgical).

In the cohort, the mean age was 63 years, 45% were male and 80% were white; 25(OH)D was ≤10 ng/mL in 8% of patients, 11–19.9 ng/mL in 24%, 20–29.9 ng/mL in 24% and ≥30 ng/mL in 44% of patients. Eighteen per cent (n=351) were diagnosed with acute respiratory failure. Compared to patients with 25(OH)D ≥30 ng/mL, patients with lower 25(OH)D levels had significantly higher adjusted odds of acute respiratory failure (≤10 ng/mL, OR=1.84 (95% CI 1.22 to 2.77); 11–19.9 ng/mL, OR=1.60 (95% CI 1.19 to 2.15); 20–29.9 ng/mL, OR=1.37 (95% CI 1.01 to 1.86)).

Conclusions Prehospital 25(OH)D was associated with the risk of acute respiratory failure in our critically ill patient cohort.

  • ARDS
  • Clinical Epidemiology

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjresp-2014-000074

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text