327 A Prospective Analysis of Hypovitaminosis D and Mortality in 400 Patients in the Neurocritical Care Setting. (August 2016)

• Record Type: Journal Article
• Authors: Guan, Jian; Karsy, Michael; Brock, Andrea Archambault; Eli, Ilyas; Ledyard, Holly; Hawryluk, Gregory W.J.; Park, Min S.
• Is Part Of: Clinical neurosurgery. Volume 63(2016)Supplement 1
• Publication Date: 2016-08
• Subjects: Nervous system -- Surgery -- Congresses; Neurosurgery; Nervous system -- Surgery; Neurologie; Congresses; Conference papers and proceedings; 617.48
• DOI: 10.1227/01.neu.0000489816.83100.d1
• Languages: English
• ISSNs: 0069-4827

Abstract

Abstract : INTRODUCTION: Hypovitaminosis D is highly prevalent among the general population. Studies have shown an association between hypovitaminosis D and multiple negative outcomes in critical care patients, but there has been no prospective evaluation of hypovitaminosis D in the neurological critical care population. The authors examined the impact of vitamin D deficiency on in-hospital mortality and a variety of secondary outcomes in the neurocritical care unit. METHODS: The authors prospectively collected 25-hydroxy vitamin D levels on all patients admitted to the neurocritical care unit of a quaternary-care center over a 3-month period. Demographic data, illness acuity, in-hospital mortality, infection, and length of hospitalization were collected. Univariate and multivariable logistic regression were used to examine the effects of vitamin D deficiency. RESULTS: Four hundred sixty-one patients met the inclusion criteria. In-hospital mortality was slightly worse (9.3% vs 4.5%, P = .059) among patients with deficient vitamin D (⩽20 ng/dL). There was also a higher rate of urinary tract infection in patients with vitamin D deficiency (12.4% vs 4.2%, P = .002). For patients admitted to the neurocritical care unit emergently (n = 285), higher SAPS II score (odds ratio [OR], 13.33; 95% confidence interval [CI], 1.69-100; P = .014) and vitamin D deficiency (OR, 3.03; 95% CI, 1.14-8.06; P = .027) were significantly associated with increased in-hospital mortality on multivariable analysis. CONCLUSION: In the subset of patients admitted to the neurocritical care unit emergently, vitamin D deficiency is significantly associated with higher in-hospital mortality. Larger studies are needed to confirm these findings and to investigate the role of vitamin D supplementation in these patients.