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Including Vitamin D test results improved 90 day ICU mortality prediction (when will they add Vitamin D to patients) – June 2016

Addition of 25-hydroxyvitamin D levels to the Deyo-Charlson Comorbidity Index improves 90-day mortality prediction in critically ill patients

J Intensive Care. 2016; 4: 40, online 2016 Jun 17. doi: 10.1186/s40560-016-0165-0
PMCID: PMC4912797
Bisundev Mahato, Tiffany M. N. Otero, Carrie A. Holland, Patrick T. Giguere, Ednan K. Bajwa, Carlos A. Camargo, Jr., and Sadeq A. Quraishi

VitaminDWiki

Vitamin D has been proven many times to reduce ICU mortality.

The items which are in both Intervention and Trauma/Surgery are listed here

Pages in BOTH of the categories: Trauma/Surgery and Mortality

Wonder when ICUs will start adding Vitamin D?

  • ICU improvements include
    • Shorter recovery time
    • Shorter ICU time
    • Reduced deaths – in hospital, next month, next year
    • Reduced Sepsis = blood poisoning = infection


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Background
The Deyo-Charlson Comorbidity Index (DCCI) has low predictive value in the intensive care unit (ICU). Our goal was to determine whether addition of 25-hydroxyvitamin D (25OHD) levels to the DCCI improved 90-day mortality prediction in critically ill patients.

Methods
Plasma 25OHD levels, DCCI, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were assessed within 24 h of admission in 310 ICU patients. Receiver operating characteristic curves of the prediction scores, without and with the addition of 25OHD levels, for 90-day mortality were constructed and the areas under the curve (AUC) were compared for equality.

Results
Mean (standard deviation) plasma 25OHD levels, DCCI, and APACHE II score were 19 (SD 8) ng/mL, 4 (SD 3), and 17 (SD 9), respectively. Overall 90-day mortality was 19 %. AUC for DCCI vs. DCCI + 25OHD was 0.68 (95 % CI 0.58–0.77) vs. 0.75 (95 % CI 0.67–0.83); p < 0.001. AUC for APACHE II vs. APACHE II + 25OHD was 0.81 (95 % CI 0.73–0.88) vs. 0.82 (95 % CI 0.75–0.89); p < 0.001. There was a significant difference between the AUC for DCCI + 25OHD and APACHE II + 25OHD (p = 0.04) but not between the AUC for DCCI + 25OHD and APACHE II (p = 0.12).

Conclusions
In our cohort of ICU patients, the addition of 25OHD levels to the DCCI improved 90-day mortality prediction compared to the DCCI alone. Moreover, the predictive capability of DCCI + 25OHD was comparable to that of APACHE II. Future prospective studies are needed to validate our findings and to determine whether the use of DCCI + 25OHD can influence clinical decision-making.


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APACHE II Wikipedia

Created by admin. Last Modification: Monday November 6, 2017 21:45:54 UTC by admin. (Version 6)

Attached files

ID Name Comment Uploaded Size Downloads
8659 ICU mortality table.jpg admin 06 Nov, 2017 21:45 21.31 Kb 12
8657 90-day mortality prediction.pdf PDF 2017 admin 06 Nov, 2017 21:29 1.09 Mb 6
8656 90-day mortality prediction.jpg admin 06 Nov, 2017 21:28 11.00 Kb 16
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