Health Services Research & Development

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Viglianti EM, Zajic P, Iwashyna TJ, Amrein K. Neither vitamin D levels nor supplementation are associated with the development of persistent critical illness: a retrospective cohort analysis. Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine. 2019 Mar 1; 21(1):39-44.
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Abstract: OBJECTIVE: The purpose of this study was to evaluate if vitamin D deficiency is associated with increased rates of persistent critical illness, and whether repletion of vitamin D among patients with this deficiency leads to decreased persistent critical illness. DESIGN: Retrospective cohort analysis. SETTING: Seven intensive care units (ICUs) at the University Medical Center of Graz, Austria, with participants recruited between July 2008 and April 2010. The VITdAL-ICU trial cohort included five ICUs at the University Medical Center of Graz, Austria, with patients recruited between May 2010 through September 2012. PARTICIPANTS: There were 628 patients aged = 18 years admitted to the ICU and who had their 25-hydroxyvitamin D (25(OH)D) level measured at least once. The VITdAL-ICU cohort included 475 patients aged = 18 years who were expected to stay in the ICU for greater than 48 hours and found to have a 25(OH)D level of = 20 ng/mL. MAIN OUTCOME MEASURES: Development of persistent critical illness. RESULTS: In the retrospective cohort, vitamin D level on admission was not significantly associated with the development of persistent critical illness compared with patients who were discharged alive earlier (relative risk ratio [RRR], 1.02; 95% CI, 1.00-1.04) or who died (RRR, 1.02; 95% CI, 0.99-1.05). In the VITdAL-ICU trial, supplementation with vitamin D3 did not lead to less persistent illness relative to patients who were discharged alive earlier (RRR, 1.19; 95% CI, 0.79-1.80) or who died (RRR, 1.34; 95% CI, 0.72-2.52). CONCLUSION: Vitamin D deficiency was not associated with persistent critical illness, nor did supplementation with vitamin D3 mitigate the development of persistent critical illness.