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Low vitamin D in Pediatric ICU – 5 times more ill (morbidity) – Spanish Nov 2016

[Vitamin D deficiency and morbimortality in critically ill paediatric patients] Spanish

An Pediatr (Barc). 2016 Nov 25. pii: S1695-4033(16)30265-X. doi: 10.1016/j.anpedi.2016.09.005.
García-Soler P1, Morales-Martínez A2, Rosa-Camacho V2, Lillo-Muñoz JA2, Milano-Manso G2.


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OBJECTIVES:
To determine the prevalence and risks factors of vitamin D deficiency, as well as its relationship with morbidity and mortality in a PICU.

MATERIAL AND METHODS:
An observational prospective study in a tertiary children's University Hospital PICU conducted in two phases: i: cohorts study, and ii: prevalence study. The study included 340 critically ill children with ages comprising 6 months to 16 years old.

EXCLUSION CRITERIA:
Chronic kidney disease, known parathyroid disorders, and vitamin D supplementation. Total 25-hydroxyvitamin D [25(OH)D] was measured in the first 48 hours of admission to a PICU. Parathormone, calcium, phosphate, blood gases, blood count, C-reactive protein, and procalcitonin were also analysed. A record was also made of demographic features, characteristics of the episode, and complications during the PICU stay.

RESULTS:
The overall prevalence rate of vitamin D deficiency was 43.8%, with a mean of 22.28 (95% CI 21.15-23.41) ng/ml.
Patients with vitamin D deficiency

  • were older (61 vs 47 months, P=.039),
  • had parents with a higher level of academic studies (36.5% vs 20%, P=.016),
  • were admitted more often in winter and spring,
  • had a higher PRISM-III (6.8 vs 5.1, P=.037),
  • a longer PICU stay (3 vs 2 days, P=.001), and
  • higher morbidity (61.1% vs 30.4%, P<001)

than the patients with sufficient levels of 25(OH)D.
Patients who died had lower levels of 25(OH)D (14±8.81ng/ml versus 22.53±10.53ng/ml, P=.012).
Adjusted OR for morbidity was 5.44 (95%CI; 2.5-11.6).

CONCLUSIONS:
Vitamin D deficiency is frequent in critically ill children, and it is related to both morbidity and mortality, although it remains unclear whether it is a causal relationship or it is simply a marker of severity in different clinical situations.

PMID: 27894744 DOI: 10.1016/j.anpedi.2016.09.005

Attached files

ID Name Comment Uploaded Size Downloads
8182 Child morbimortality.pdf PDF 2017 admin 15 Jul, 2017 11:57 647.92 Kb 2
7446 Déficit de vitamina D y morbimortalidad en pacientes criticos pediatricos.pdf PDF 2016 admin 05 Dec, 2016 17:38 483.83 Kb 46
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