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Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk

Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients...

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Autores principales: Cappello, Silvia, Cereda, Emanuele, Rondanelli, Mariangela, Klersy, Catherine, Cameletti, Barbara, Albertini, Riccardo, Magno, Daniela, Caraccia, Marilisa, Turri, Annalisa, Caccialanza, Riccardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295045/
https://www.ncbi.nlm.nih.gov/pubmed/28025528
http://dx.doi.org/10.3390/nu9010001
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author Cappello, Silvia
Cereda, Emanuele
Rondanelli, Mariangela
Klersy, Catherine
Cameletti, Barbara
Albertini, Riccardo
Magno, Daniela
Caraccia, Marilisa
Turri, Annalisa
Caccialanza, Riccardo
author_facet Cappello, Silvia
Cereda, Emanuele
Rondanelli, Mariangela
Klersy, Catherine
Cameletti, Barbara
Albertini, Riccardo
Magno, Daniela
Caraccia, Marilisa
Turri, Annalisa
Caccialanza, Riccardo
author_sort Cappello, Silvia
collection PubMed
description Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients at nutritional risk has not been assessed. Methods: In this five-year prospective study, we investigated whether high vitamin B12 concentrations (>1000 pg/mL) are associated with in-hospital mortality in 1373 not-bed-ridden adult patients at nutritional risk (Nutrition Risk Index <97.5), admitted to medical and surgical departments. Results: Three hundred and ninety-six (28.8%) patients presented vitamin B12 > 1000 pg/mL. Two hundred and four patients died in the hospital (14.9%). The adjusted odds ratio of in-hospital mortality in patients with high vitamin B12 was 2.20 (95% CI, 1.56–3.08; p < 0.001); it was independent of age, gender, body mass index, six-month previous unintentional weight loss, admission ward, presence of malignancy, renal function, C-reactive protein and prealbumin. Patients with high vitamin B12 also had a longer length of stay (LOS) than those with normal concentrations (median 25 days, (IQR 15–41) versus 23 days (IQR 14–36); p = 0.014), and elevated vitamin B12 was an independent predictor of LOS (p = 0.027). Conclusions: An independent association between elevated vitamin B12 concentrations, mortality and LOS was found in our sample of hospitalized adult patients at nutritional risk. Although the underlying mechanisms are still unknown and any cause-effect relation cannot be inferred, clinicians should be aware of the potential negative impact of high vitamin B12 concentrations in hospitalized patients at nutritional risk and avoid inappropriate vitamin supplementation.
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spelling pubmed-52950452017-02-10 Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk Cappello, Silvia Cereda, Emanuele Rondanelli, Mariangela Klersy, Catherine Cameletti, Barbara Albertini, Riccardo Magno, Daniela Caraccia, Marilisa Turri, Annalisa Caccialanza, Riccardo Nutrients Article Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients at nutritional risk has not been assessed. Methods: In this five-year prospective study, we investigated whether high vitamin B12 concentrations (>1000 pg/mL) are associated with in-hospital mortality in 1373 not-bed-ridden adult patients at nutritional risk (Nutrition Risk Index <97.5), admitted to medical and surgical departments. Results: Three hundred and ninety-six (28.8%) patients presented vitamin B12 > 1000 pg/mL. Two hundred and four patients died in the hospital (14.9%). The adjusted odds ratio of in-hospital mortality in patients with high vitamin B12 was 2.20 (95% CI, 1.56–3.08; p < 0.001); it was independent of age, gender, body mass index, six-month previous unintentional weight loss, admission ward, presence of malignancy, renal function, C-reactive protein and prealbumin. Patients with high vitamin B12 also had a longer length of stay (LOS) than those with normal concentrations (median 25 days, (IQR 15–41) versus 23 days (IQR 14–36); p = 0.014), and elevated vitamin B12 was an independent predictor of LOS (p = 0.027). Conclusions: An independent association between elevated vitamin B12 concentrations, mortality and LOS was found in our sample of hospitalized adult patients at nutritional risk. Although the underlying mechanisms are still unknown and any cause-effect relation cannot be inferred, clinicians should be aware of the potential negative impact of high vitamin B12 concentrations in hospitalized patients at nutritional risk and avoid inappropriate vitamin supplementation. MDPI 2016-12-23 /pmc/articles/PMC5295045/ /pubmed/28025528 http://dx.doi.org/10.3390/nu9010001 Text en © 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cappello, Silvia
Cereda, Emanuele
Rondanelli, Mariangela
Klersy, Catherine
Cameletti, Barbara
Albertini, Riccardo
Magno, Daniela
Caraccia, Marilisa
Turri, Annalisa
Caccialanza, Riccardo
Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk
title Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk
title_full Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk
title_fullStr Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk
title_full_unstemmed Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk
title_short Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk
title_sort elevated plasma vitamin b12 concentrations are independent predictors of in-hospital mortality in adult patients at nutritional risk
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295045/
https://www.ncbi.nlm.nih.gov/pubmed/28025528
http://dx.doi.org/10.3390/nu9010001
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