Cargando…

Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay

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 neurosurgica...

Descripción completa

Detalles Bibliográficos
Autores principales: Ved, Ronak, Taylor, Peter, Stewart, Philippa, Foulkes, Jonathan, Fields‐Jewell, Wilem, Davies, Steve, Hayhurst, Caroline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947696/
https://www.ncbi.nlm.nih.gov/pubmed/31922024
http://dx.doi.org/10.1002/edm2.97
_version_ 1783485607966670848
author Ved, Ronak
Taylor, Peter
Stewart, Philippa
Foulkes, Jonathan
Fields‐Jewell, Wilem
Davies, Steve
Hayhurst, Caroline
author_facet Ved, Ronak
Taylor, Peter
Stewart, Philippa
Foulkes, Jonathan
Fields‐Jewell, Wilem
Davies, Steve
Hayhurst, Caroline
author_sort Ved, Ronak
collection PubMed
description 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.
format Online
Article
Text
id pubmed-6947696
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-69476962020-01-09 Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay Ved, Ronak Taylor, Peter Stewart, Philippa Foulkes, Jonathan Fields‐Jewell, Wilem Davies, Steve Hayhurst, Caroline Endocrinol Diabetes Metab Original Articles 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. John Wiley and Sons Inc. 2019-11-03 /pmc/articles/PMC6947696/ /pubmed/31922024 http://dx.doi.org/10.1002/edm2.97 Text en © 2019 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Ved, Ronak
Taylor, Peter
Stewart, Philippa
Foulkes, Jonathan
Fields‐Jewell, Wilem
Davies, Steve
Hayhurst, Caroline
Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay
title Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay
title_full Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay
title_fullStr Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay
title_full_unstemmed Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay
title_short Vitamin D deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay
title_sort vitamin d deficiency is endemic in neurosurgical patients and is associated with a longer length of inpatient stay
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947696/
https://www.ncbi.nlm.nih.gov/pubmed/31922024
http://dx.doi.org/10.1002/edm2.97
work_keys_str_mv AT vedronak vitaminddeficiencyisendemicinneurosurgicalpatientsandisassociatedwithalongerlengthofinpatientstay
AT taylorpeter vitaminddeficiencyisendemicinneurosurgicalpatientsandisassociatedwithalongerlengthofinpatientstay
AT stewartphilippa vitaminddeficiencyisendemicinneurosurgicalpatientsandisassociatedwithalongerlengthofinpatientstay
AT foulkesjonathan vitaminddeficiencyisendemicinneurosurgicalpatientsandisassociatedwithalongerlengthofinpatientstay
AT fieldsjewellwilem vitaminddeficiencyisendemicinneurosurgicalpatientsandisassociatedwithalongerlengthofinpatientstay
AT daviessteve vitaminddeficiencyisendemicinneurosurgicalpatientsandisassociatedwithalongerlengthofinpatientstay
AT hayhurstcaroline vitaminddeficiencyisendemicinneurosurgicalpatientsandisassociatedwithalongerlengthofinpatientstay