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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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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 |
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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 |
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