Neither vitamin D levels nor supplementation are associated with the development of persistent critical illness: a retrospective cohort analysis

Elizabeth M Viglianti, Paul Zajic, Theodore J Iwashyna, Karin Amrein
Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine 2019, 21 (1): 39-44

OBJECTIVE: The purpose of this study was to evaluate if vitamin D deficiency is associated with increased rates of persistent critical illness, and whether repletion of vitamin D among patients with this deficiency leads to decreased persistent critical illness.

DESIGN: Retrospective cohort analysis.

SETTING: Seven intensive care units (ICUs) at the University Medical Center of Graz, Austria, with participants recruited between July 2008 and April 2010. The VITdAL-ICU trial cohort included five ICUs at the University Medical Center of Graz, Austria, with patients recruited between May 2010 through September 2012.

PARTICIPANTS: There were 628 patients aged ≥ 18 years admitted to the ICU and who had their 25-hydroxyvitamin D (25(OH)D) level measured at least once. The VITdAL-ICU cohort included 475 patients aged ≥ 18 years who were expected to stay in the ICU for greater than 48 hours and found to have a 25(OH)D level of ≤ 20 ng/mL.

MAIN OUTCOME MEASURES: Development of persistent critical illness.

RESULTS: In the retrospective cohort, vitamin D level on admission was not significantly associated with the development of persistent critical illness compared with patients who were discharged alive earlier (relative risk ratio [RRR], 1.02; 95% CI, 1.00-1.04) or who died (RRR, 1.02; 95% CI, 0.99-1.05). In the VITdAL-ICU trial, supplementation with vitamin D3 did not lead to less persistent illness relative to patients who were discharged alive earlier (RRR, 1.19; 95% CI, 0.79-1.80) or who died (RRR, 1.34; 95% CI, 0.72-2.52).

CONCLUSION: Vitamin D deficiency was not associated with persistent critical illness, nor did supplementation with vitamin D3 mitigate the development of persistent critical illness.

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