Vitamin D Insufficiency and Sepsis Severity in Emergency Department Patients With Suspected Infection
Open Access
- 22 April 2011
- journal article
- other
- Published by Wiley in Academic Emergency Medicine
- Vol. 18 (5), 551-554
- https://doi.org/10.1111/j.1553-2712.2011.01047.x
Abstract
ACADEMIC EMERGENCY MEDICINE 2011; 18:551–554 © 2011 by the Society for Academic Emergency Medicine Abstract Objectives: Vitamin D is increasingly recognized as an important mediator of immune function and may have a preventive role in the pathogenesis of sepsis. We sought to evaluate the association between vitamin D status and sepsis severity and hypothesized that vitamin D insufficiency would be associated with increased sepsis severity. Methods: This was a pilot study of emergency department (ED) patients age ≥18 years evaluated for suspected infection at an urban, teaching hospital. The authors measured illness severity using the following assessments at baseline and 24 hours: 1) severe sepsis, defined as suspected infection plus two or more elements of systemic inflammatory response syndrome criteria and acute dysfunction of one or more organ systems; 2) Acute Physiology Age Chronic Health Evaluation (APACHE) II scores; and 3) Sepsis‐related Organ Failure Assessment (SOFA) scores. Vitamin D insufficiency was defined as baseline serum 25‐hydroxyvitamin D (25OHD) levels = 0.006) and SOFA scores ≥2 (44% vs. 18%; p = 0.049). Additionally, at 24 hours, those with 25OHD levels of = 0.005), dysfunction of two or more organ systems (50% vs. 18%; p = 0.02), APACHE II score of ≥25 (19% vs. 0%; p = 0.06), and SOFA scores of ≥2 (63% vs. 29%; p = 0.02). Additionally, all four patients who died during the index hospitalization had 25OHD levels of <75 nmol/L. Conclusions: Vitamin D insufficiency was associated with higher sepsis severity in ED patients hospitalized for suspected infection. Larger observational studies, mechanistic studies, and ultimately randomized controlled trials are needed to determine causation and to evaluate if vitamin D supplementation can reduce the risk of sepsis as a preventive or therapeutic strategy.Keywords
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