Das Sarthak, M Kiran Kumar, Biswal Niranjan, Parameswaran Narayanan, Nanda Nivedita
Paediatrics, All India Institute of Medical Sciences, Mangalagiri, IND.
Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.
Cureus. 2020 Sep 9;12(9):e10322. doi: 10.7759/cureus.10322.
Introduction The study aims to evaluate the association between a deficiency of Vitamin D level with the duration of hospital stay, pediatric intensive care unit (PICU) stay, and ventilation; the pediatric risk of mortality (PRISM) score, and the rate of readmission. Materials and methods This prospective observational study was conducted from November 2014 to October 2015, and the study population consisted of children admitted to the pediatric intensive care unit (PICU) in a tertiary care hospital of Puducherry. After measuring vitamin D levels, children were allotted into three categories depending on their serum 25(OH)D levels as the sufficient group (25[OH]D level ≥ 30 ng/mL), insufficient group (25[OH]D level = 20 - 29.9 ng/mL), and deficient group (25[OH]D level < 20 ng/mL). Among these three groups, the duration of hospital stay, PICU stay, and ventilation; the PRISM score, and the rate of readmission were compared. Results A total of 522 patients were included in the study. Based on their 25(OH)D level, 222 patients (42.5%) were in the sufficient category, 153 patients (29.3%) were in the deficient category, and 147 patients (28.2%) were in the insufficient category. Vitamin D deficiency state is not statistically significantly associated with the duration of hospital stay (P = .84), duration of PICU stay (P = .69), duration of ventilation (P = .48), PRISM score (P = .63), and rate of readmission (P = .91). Conclusions Longer hospital stay, prolonged PICU stay, longer duration of ventilation, and higher PRISM III score were independent risk factors for higher mortality in the PICU. However, lower vitamin D levels are not statistically significant to predict mortality among the study population.
引言 本研究旨在评估维生素D水平缺乏与住院时间、儿科重症监护病房(PICU)住院时间、通气时间;儿科死亡风险(PRISM)评分以及再入院率之间的关联。材料与方法 本前瞻性观察性研究于2014年11月至2015年10月进行,研究对象为在本地治里一家三级护理医院儿科重症监护病房(PICU)住院的儿童。在测量维生素D水平后,根据儿童血清25(OH)D水平将其分为三类:充足组(25[OH]D水平≥30 ng/mL)、不足组(25[OH]D水平=20 - 29.9 ng/mL)和缺乏组(25[OH]D水平<20 ng/mL)。比较这三组的住院时间、PICU住院时间、通气时间;PRISM评分以及再入院率。结果 本研究共纳入522例患者。根据其25(OH)D水平,222例患者(42.5%)属于充足类别,153例患者(29.3%)属于缺乏类别,147例患者(28.2%)属于不足类别。维生素D缺乏状态与住院时间(P = 0.84)、PICU住院时间(P = 0.69)、通气时间(P = 0.48)、PRISM评分(P = 0.63)以及再入院率(P = 0.91)之间无统计学显著关联。结论 住院时间延长、PICU住院时间延长、通气时间延长以及PRISM III评分较高是PICU死亡率升高的独立危险因素。然而,较低的维生素D水平对预测研究人群中的死亡率无统计学显著意义。