Neither vitamin D levels nor supplementation are associated with the development of persistent critical illness: a retrospective cohort analysis.

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.