Prevalence and clinical impact of vitamin D deficiency in critically ill Korean patients with traumatic injuries: a single-center, prospective, observational study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: This study investigated the prevalence and impact of 25-hydroxyvitamin D (25(OH) vitamin D) deficiency in critically ill Korean patients with traumatic injuries. Methods: This prospective observational cohort study assessed the 25(OH) vitamin D status of consecutive trauma patients admitted to the trauma intensive care unit (TICU) of Kyungpook National University Hospital between January and December 2018. We analyzed the prevalence of 25(OH) vitamin D deficiency and its impact on clinical outcomes. Results: There were no significant differences in the duration of mechanical ventilation (MV), lengths of TICU and hospital stays, and rates of nosocomial infection and mortality between patients with 25(OH) vitamin D <20 ng/ml and those with 25(OH) vitamin D ≥20 ng/ml within 24 hours of TICU admission. The duration of MV and lengths of TICU and hospital stays were shorter and the rate of nosocomial infection was lower in patients with 25(OH) vitamin D level ≥20 ng/ml on day 7 of hospitalization. The duration of MV, lengths of TICU and hospital stays, and nosocomial infection rate were significantly lower in patients with increased concentrations compared with those with decreased concentrations on day 7 of hospitalization, but the mortality rate did not differ significantly. Conclusions: The 25(OH) vitamin D level measured within 24 hours after TICU admission was unrelated to clinical outcomes in critically ill patients with traumatic injuries. However, patients with increased 25(OH) vitamin D level after 7 days of hospitalization had better clinical outcomes than those with decreased levels.
Abstract
Background: This study investigated the prevalence and impact of 25-hydroxyvitamin D (25(OH) vitamin D) deficiency in critically ill Korean patients with traumatic injuries. Methods: This prospective observational cohort study assessed the 25(OH) vitamin D status of consecutive trauma patients admitted to the trauma intensive care unit (TICU) of Kyungpook National University Hospital between January and December 2018. We analyzed the prevalence of 25(OH) vitamin D deficiency and its impact on clinical outcomes. Results: There were no significant differences in the duration of mechanical ventilation (MV), lengths of TICU and hospital stays, and rates of nosocomial infection and mortality between patients with 25(OH) vitamin D <20 ng/ml and those with 25(OH) vitamin D ≥20 ng/ml within 24 hours of TICU admission. The duration of MV and lengths of TICU and hospital stays were shorter and the rate of nosocomial infection was lower in patients with 25(OH) vitamin D level ≥20 ng/ml on day 7 of hospitalization. The duration of MV, lengths of TICU and hospital stays, and nosocomial infection rate were significantly lower in patients with increased concentrations compared with those with decreased concentrations on day 7 of hospitalization, but the mortality rate did not differ significantly. Conclusions: The 25(OH) vitamin D level measured within 24 hours after TICU admission was unrelated to clinical outcomes in critically ill patients with traumatic injuries. However, patients with increased 25(OH) vitamin D level after 7 days of hospitalization had better clinical outcomes than those with decreased levels.
참고문헌 (19)
- Choi HS, "Vitamin D insufficiency in Korea : a greater threat to younger generation : the Korea National Health and Nutrition Examination Survey(KNHANES)2008", J Clin Endocrinol Metab, 96, pp.643~651 (2011)
- Schwalfenberg GK, "A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency", Mol Nutr Food Res, 55, pp.96~108 (2011)
- Jeng L, "Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis", J Transl Med, 7, pp.28~ (2009)
- Holick MF, "Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline", J Clin Endocrinol Metab, 96, pp.1911~1930 (2011)
- Lee P, "Vitamin D deficiency in the intensive care unit: an invisible accomplice to morbidity and mortality?", Intensive Care Med, 35, pp.2028~2032 (2009)
- Lee P, "Vitamin D deficiency in critically ill patients", N Engl J Med, 360, pp.1912~1914 (2009)
- Higgins DM, "Relationship of vitamin D deficiency to clinical outcomes in critically ill patients", JPEN J Parenter Enteral Nutr, 36, pp.713~720 (2012)
- Matthews LR, "Worsening 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", Am J Sur, 204, pp.37~43 (2012)
- Quraishi SA, "Prospective study of vitamin D status at initiation of care in critically ill surgical patients and risk of 90-day mortality", Crit Care Med, 42, pp.1365~1371 (2014)
- de Haan K, "Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: systematic review and meta-analysis", Crit Care, 18, pp.660~ (2014)
- Dickerson RN, "Vitamin D deficiency in critically ill patients with traumatic injuries", Burns Trauma, 4, pp.28~ (2016)
- Blay B, "Low vitamin D level on admission for burn injury is associated with increased length of stay", J Burn Care Res, 38, pp.e8~e13 (2017)
- Gueye Y, "Cholecalciferol(vitamin D₃)improves functional recovery when delivered during the acute phase after a spinal cord trauma", J Steroid Biochem Mol Biol, 154, pp.23~31 (2015)
- Toman E, "Vitamin D deficiency in traumatic brain injury and its relationship with severity of injury and quality of life: a prospective, observational study", J Neurotrauma, 34, pp.1448~1456 (2017)
- Flynn L, "Effects of vitamin D deficiency in critically ill surgical patients", Am J Surg, 203, pp.379~382 (2012)
- Quraishi SA, "Plasma 25-Hydroxyvitamin D levels at initiation of care and duration of mechanical ventilation in critically ill surgical patients", JPEN J Parenter Enteral Nutr, 40, pp.273~278 (2016)
- Brook K, "Admission vitamin D status is associated with discharge destination in critically ill surgical patients", Ann Intensive Care, 5, pp.23~ (2015)
- Jamall OA, "Prevalence and correlates of vitamin D deficiency in adults after traumatic brain injury", Clin Endocrinol(Oxf), 85, pp.636~644 (2016)
- Anwar E, "Burden and outcome of vitamin D deficiency among critically ill patients : a prospective study", Nutr Clin Pract, 32, pp.378~384 (2017)