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Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit

Introduction This study aims to evaluate the prevalence of vitamin D deficiency and the correlation between serum 25-hydroxyvitamin D (25(OH)D) and mortality. Materials and methods A prospective observational study was conducted among 522 children admitted to the Pediatric Intensive Care Unit in the...

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Autores principales: M, Kiran kumar, Das, Sarthak, Biswal, Niranjan, Parameswaran, Narayanan, Nanda, Nivedita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331776/
https://www.ncbi.nlm.nih.gov/pubmed/32626628
http://dx.doi.org/10.7759/cureus.8413
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author M, Kiran kumar
Das, Sarthak
Biswal, Niranjan
Parameswaran, Narayanan
Nanda, Nivedita
author_facet M, Kiran kumar
Das, Sarthak
Biswal, Niranjan
Parameswaran, Narayanan
Nanda, Nivedita
author_sort M, Kiran kumar
collection PubMed
description Introduction This study aims to evaluate the prevalence of vitamin D deficiency and the correlation between serum 25-hydroxyvitamin D (25(OH)D) and mortality. Materials and methods A prospective observational study was conducted among 522 children admitted to the Pediatric Intensive Care Unit in the Pediatrics Department of the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. After measuring vitamin D levels, children were assigned into three groups based on their serum 25(OH)D levels: a sufficient group (25(OH)D level ≥ 30 ng/mL), an insufficient group (25(OH)D level = 20-29.9 ng/mL), and a deficient group (25(OH)D level < 20 ng/mL). Each group was again divided into two sub-groups (survivors and non-survivors if death was the outcome), and then each sub-group was again divided into two groups (sepsis and all non-septic causes). Results were evaluated for an association with mortality. Results A majority (66.6%) of patients who died had low levels of 25(OH)D (deficient = 37.9%; insufficient = 28.7%). Mortality was higher in children with 25(OH)D deficiency (P = 0.03). In univariate analysis, 25(OH)D deficiency was strongly associated with sepsis in children according to our observation, with 51% from the deficient group, 38% from the insufficient group, and 27.5% from the sufficient group (P ≤ 0.01). Mortality is not associated with 25(OH)D deficiency or insufficiency in multilogistic regression analysis. A serum vitamin D level of 20 ng/mL can predict higher mortality, with a specificity of 62.1%. Conclusions Vitamin D supplementation may be recommended for PICU-admitted cases to decrease the risk of sepsis. This association can be explored more in the future among the community population for further recommendations.
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spelling pubmed-73317762020-07-02 Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit M, Kiran kumar Das, Sarthak Biswal, Niranjan Parameswaran, Narayanan Nanda, Nivedita Cureus Emergency Medicine Introduction This study aims to evaluate the prevalence of vitamin D deficiency and the correlation between serum 25-hydroxyvitamin D (25(OH)D) and mortality. Materials and methods A prospective observational study was conducted among 522 children admitted to the Pediatric Intensive Care Unit in the Pediatrics Department of the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. After measuring vitamin D levels, children were assigned into three groups based on their serum 25(OH)D levels: a sufficient group (25(OH)D level ≥ 30 ng/mL), an insufficient group (25(OH)D level = 20-29.9 ng/mL), and a deficient group (25(OH)D level < 20 ng/mL). Each group was again divided into two sub-groups (survivors and non-survivors if death was the outcome), and then each sub-group was again divided into two groups (sepsis and all non-septic causes). Results were evaluated for an association with mortality. Results A majority (66.6%) of patients who died had low levels of 25(OH)D (deficient = 37.9%; insufficient = 28.7%). Mortality was higher in children with 25(OH)D deficiency (P = 0.03). In univariate analysis, 25(OH)D deficiency was strongly associated with sepsis in children according to our observation, with 51% from the deficient group, 38% from the insufficient group, and 27.5% from the sufficient group (P ≤ 0.01). Mortality is not associated with 25(OH)D deficiency or insufficiency in multilogistic regression analysis. A serum vitamin D level of 20 ng/mL can predict higher mortality, with a specificity of 62.1%. Conclusions Vitamin D supplementation may be recommended for PICU-admitted cases to decrease the risk of sepsis. This association can be explored more in the future among the community population for further recommendations. Cureus 2020-06-02 /pmc/articles/PMC7331776/ /pubmed/32626628 http://dx.doi.org/10.7759/cureus.8413 Text en Copyright © 2020, M et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
M, Kiran kumar
Das, Sarthak
Biswal, Niranjan
Parameswaran, Narayanan
Nanda, Nivedita
Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit
title Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit
title_full Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit
title_fullStr Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit
title_full_unstemmed Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit
title_short Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit
title_sort vitamin d status at admission and its association with mortality in children admitted to the pediatric intensive care unit
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331776/
https://www.ncbi.nlm.nih.gov/pubmed/32626628
http://dx.doi.org/10.7759/cureus.8413
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