Deficiency in 25-hydroxyvitamin D and 30-day mortality in patients with severe sepsis and septic shock

Abstract

Background: Vitamin D has immunomodulating properties. Objective To determine if vitamin D deficiency within 30 days of admission to the intensive care unit in patients with sepsis might be associated with increased all-cause 30-day mortality. Methods: In a retrospective cohort study at a large, tertiary, urban, academic medical center, records of patients who had 25-hydroxyvitamin D levels measured within 30 days of admission for severe sepsis or septic shock from June 2006 to April 2011 were examined. Patients were considered deficient in vitamin D if its serum concentration was 15 ng/mL or less. The primary outcome of interest was 30-day mortality. Results: Among the 121 patients in the sample, 65 (54%) were vitamin D deficient. Baseline demographics were similar between vitamin D deficient and nondeficient groups, except that the vitamin D deficient group had more African Americans (P=.01). All-cause 30-day mortality was significantly higher in patients deficient in vitamin D (37% vs 20%; P =.04) and remained higher at 90 days (51% vs 25%, P =.005). In multivariate analysis, age (odds ratio, 1.04; 95% CI 1.01-1.07; P =.01) and vitamin D deficiency (odds ratio, 2.7; 95% CI, 1.39-18.8; P =.02) were independently associated with increased 30-day mortality. Conclusion: Patients deficient in vitamin D within 30 days of hospital admission for severe sepsis or septic shock may be at increased risk for all-cause 30-day mortality. © 2014 American Association of Critical-Care Nurses.