Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay. Issue 1 (3rd November 2019)

• Record Type: Journal Article
• Authors: Ved, Ronak; Taylor, Peter; Stewart, Philippa; Foulkes, Jonathan; Fields‐Jewell, Wilem; Davies, Steve; Hayhurst, Caroline
• Is Part Of: Endocrinology, diabetes & metabolism. Volume 3:Issue 1(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-11-03
• Subjects: neuroendocrinology -- neurosurgery -- surgery -- vitamin D; Endocrinology -- Periodicals; Diabetes -- Periodicals; Metabolism -- Periodicals; 616.4
• DOI: 10.1002/edm2.97
• Languages: English
• ISSNs: 2398-9238

Abstract

Abstract: Introduction: Vitamin D deficiency is common in spinal surgery and critical care. Hypovitaminosis D may impact on outcomes in cranial neurosurgical care and play roles in underlying disease processes. Methods: A prospective observational cohort study was performed. All emergency cranial neurosurgical ward admissions from 1st January to 10th May 2017 were screened for inclusion (n = 406). Patients already receiving vitamin D supplementation, spinal patients and elective admissions were excluded. Admission vitamin D levels were checked for all remaining patients (n = 95). Patients with vitamin D <30 nmol/L were defined as "deficient" and those 30‐50 nmol/L as "inadequate." All patients with levels <50 nmol/L were replaced, as per local guidelines. Descriptive analyses of the cohorts were undertaken, with multivariate regression used to assess the effect of vitamin D on length of stay, inpatient morbidity and mortality. Results: The median age of participants was 61 years (n = 95; 57% male, 43% female). The median vitamin D level was 23 nmol/L (deficient). 84% (n = 80) of patients had low vitamin D levels, with 61% (n = 58) classed as deficient (<30 nmol/L). Vitamin D deficiency rates were similar in those aged below 65 years (86%; n = 38/44) and those above 65 years (82%; n = 42/51). Deficient vitamin D level was associated with longer hospital stay ( P = .03), and this relationship persisted after adjusting for potential confounders such as age, sex and preadmission Charlson co‐morbidity index. No statistically significant association was seen with vitamin D status and inpatient morbidity or mortality. Conclusions: Vitamin D deficiency is common in cranial neurosurgical patients, even in predefined low‐risk groups (age <65). Lower vitamin D level was associated with longer length of stay. This study supports the need for: (a) further investigation into the roles of vitamin D in neurosurgical pathologies and management and (b) an appropriately powered, randomised investigation into the impact of vitamin D status upon neurosurgical diagnoses and complications. Abstract : Vitamin D deficiency may have negative impacts upon clinical outcomes of surgical patients. The prevalence of hypovitaminosis D was identified in a cohort of emergency neurosurgical patients (84%; n = 80/95). Low vitamin D was significantly associated with a prolonged inpatient stay. There is a need for a larger investigation into the clinical impact of hypovitaminosis D upon neurosurgical diagnoses and complications.