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维生素D缺乏与动脉瘤性蛛网膜下腔出血患者的预后无关:一项病例对照研究。

Vitamin D Deficiency Is Not Associated with Outcomes in Aneurysmal Subarachnoid Hemorrhage Patients: A Case Control Study.

作者信息

Alvarado Reyes Yarelis, Perez Alexandra, Rodriguez-Vega Gloria

机构信息

Department of Pharmacy Practice, Nova Southeastern University College of Pharmacy, San Juan, Puerto Rico.

Department of Sociobehavioral and Administrative Pharmacy, Nova Southeastern University College of Pharmacy, Fort Lauderdale, Florida, USA.

出版信息

World Neurosurg. 2017 Jan;97:501-504. doi: 10.1016/j.wneu.2016.10.033. Epub 2016 Oct 15.

Abstract

OBJECTIVE

Vitamin D deficiency has been associated with increased risk and adverse outcomes in many clinical settings including cardiovascular disease, stroke, and critically ill patients. Therefore we aimed to determine whether vitamin D deficiency had any effect in aneurysmal subarachnoid hemorrhage (aSAH) clinical outcomes.

METHODS

A retrospective record review was conducted in a tertiary community hospital in Puerto Rico. Adult patients admitted to the neurosurgical intensive care unit with a diagnosis of aSAH from January 2013 to July 2014, who had a 25-hydroxyvitamin-D level drawn, were included.

RESULTS

A total of 40 patients were admitted with a diagnosis of aSAH, and 33 met the inclusion criteria. Overall, 81% of patients were vitamin D deficient or insufficient. Subjects were grouped into those with vitamin D deficiency (n = 13) and those without (n = 20). Except for a larger prevalence of coronary artery disease, all other baseline parameters were similar. No significant difference in hospital mortality was observed (P = 0.676). The percentage of vasospasms, vasopressor use, hydrocephalus, and infections was also similar. An increase in length of neurosurgical intensive care unit stay and respiratory failure was observed in the vitamin D-deficient group, but it was not statistically significant.

CONCLUSION

A high prevalence of vitamin D deficiency and insufficiency was found among patients admitted with a diagnosis of aSAH in this cohort. Despite this no difference in clinical outcomes was observed in patients when compared by vitamin D group. Further studies are needed to assess potential effects of vitamin D deficiency in this patient population including long term follow-up after discharge.

摘要

目的

维生素D缺乏与包括心血管疾病、中风和重症患者在内的许多临床情况下的风险增加及不良后果相关。因此,我们旨在确定维生素D缺乏是否对动脉瘤性蛛网膜下腔出血(aSAH)的临床结局有任何影响。

方法

在波多黎各的一家三级社区医院进行了一项回顾性记录审查。纳入2013年1月至2014年7月入住神经外科重症监护病房且诊断为aSAH并检测了25-羟维生素D水平的成年患者。

结果

共有40例患者被诊断为aSAH入院,33例符合纳入标准。总体而言,81%的患者维生素D缺乏或不足。受试者被分为维生素D缺乏组(n = 13)和非缺乏组(n = 20)。除冠心病患病率较高外,所有其他基线参数相似。未观察到医院死亡率有显著差异(P = 0.676)。血管痉挛、血管升压药使用、脑积水和感染的百分比也相似。维生素D缺乏组神经外科重症监护病房住院时间和呼吸衰竭有所增加,但无统计学意义。

结论

在该队列中,诊断为aSAH入院的患者中维生素D缺乏和不足的患病率较高。尽管如此,按维生素D组比较时,患者的临床结局未观察到差异。需要进一步研究来评估维生素D缺乏对该患者群体的潜在影响,包括出院后的长期随访。

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