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血清维生素D水平与外科重症监护病房患者预后的关系

The Relationship of Serum Vitamin D Level With the Outcome in Surgical Intensive Care Unit Patients.

作者信息

Sanaie Sarvin, Mahmoodpoor Ata, Hamishehkar Hadi, Fattahi Shirin, Soleymani Saideh, Faramarzi Elnaz

机构信息

Tuberculosis and lung disease research center, Tabriz University of Medical Sciences, Tabriz, Iran.

Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Iran J Pharm Res. 2019 Spring;18(2):1052-1059. doi: 10.22037/ijpr.2019.1100658.

Abstract

The aim of this study was to assess the correlation of serum vitamin D with ICU length of stay, mortality rate, length of mechanical ventilation, and incidence of sepsis. We conducted a descriptive analytic study on 793 patients admitted to surgical ICU wards in northwest of Iran from March 2015 to March 2016. Patients were assessed during the ICU stay and the following data were collected: Glasgow Coma Score (GCS), APACHE II score, incidence of sepsis, duration of mechanical ventilation, LoS, mortality rate, and laboratory data (such as serum vitamin D, calcium, phosphorus, etc). The effect of vitamin D deficiency and the confounding factors on length of stay was assessed using the multinomial regression. Of 793 patients, 161 patients (20.3%) were in vitamin D deficiency group, 306 (38.6%) in vitamin D insufficiency group, 326 (41.1%) in vitamin D sufficiency group. Vitamin D deficiency increased risk of sepsis (OR = 22.93; 95%CI: 10.631-49.78) and mortality rate (OR = 42.93; 95%CI: 15.2-121.22). Vitamin D deficiency/insufficiency is a result of chronic and severe comorbidities of patients and can be considered as a helper but not a real risk factor for mortality and its level should be assessed in surgical critically ill patients. The way that various levels of vitamin D impact outcome in critically ill patients remains to be elucidated and further multi-center trials are needed to validate our results.

摘要

本研究的目的是评估血清维生素D与重症监护病房(ICU)住院时间、死亡率、机械通气时间和脓毒症发生率之间的相关性。我们对2015年3月至2016年3月期间入住伊朗西北部外科ICU病房的793例患者进行了描述性分析研究。在患者入住ICU期间对其进行评估,并收集以下数据:格拉斯哥昏迷评分(GCS)、急性生理与慢性健康状况评分系统II(APACHE II)评分、脓毒症发生率、机械通气时间、住院时间、死亡率以及实验室数据(如血清维生素D、钙、磷等)。使用多项回归评估维生素D缺乏和混杂因素对住院时间的影响。793例患者中,161例(20.3%)为维生素D缺乏组,306例(38.6%)为维生素D不足组,326例(41.1%)为维生素D充足组。维生素D缺乏会增加脓毒症风险(比值比[OR]=22.93;95%置信区间[CI]:10.631 - 49.78)和死亡率(OR = 42.93;95%CI:15.2 - 121.22)。维生素D缺乏/不足是患者慢性和严重合并症的结果,可被视为一种辅助因素,但并非死亡的真正风险因素,应在外科重症患者中评估其水平。不同水平的维生素D对重症患者预后的影响方式仍有待阐明,需要进一步的多中心试验来验证我们的结果。

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Vitamin D Status and Supplementation in the Critically Ill.危重症患者的维生素D状态与补充情况
Curr Gastroenterol Rep. 2016 Apr;18(4):18. doi: 10.1007/s11894-016-0492-2.

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