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韩国创伤重症患者维生素D缺乏的患病率及临床影响:一项单中心、前瞻性、观察性研究

Prevalence and clinical impact of vitamin D deficiency in critically ill Korean patients with traumatic injuries: a single-center, prospective, observational study.

作者信息

Lim Kyoung Hoon, Jang Jihoon, Park Jinyoung

机构信息

Trauma Center, Department of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

出版信息

Acute Crit Care. 2021 May;36(2):92-98. doi: 10.4266/acc.2020.00801. Epub 2021 Apr 29.

Abstract

BACKGROUND

This study investigated the prevalence and impact of 25-hydroxyvitamin D (25(OH) vitamin D) deficiency in critically ill Korean patients with traumatic injuries.

METHODS

This prospective observational cohort study assessed the 25(OH) vitamin D status of consecutive trauma patients admitted to the trauma intensive care unit (TICU) of Kyungpook National University Hospital between January and December 2018. We analyzed the prevalence of 25(OH) vitamin D deficiency and its impact on clinical outcomes.

RESULTS

There were no significant differences in the duration of mechanical ventilation (MV), lengths of TICU and hospital stays, and rates of nosocomial infection and mortality between patients with 25(OH) vitamin D <20 ng/ml and those with 25(OH) vitamin D ≥20 ng/ml within 24 hours of TICU admission. The duration of MV and lengths of TICU and hospital stays were shorter and the rate of nosocomial infection was lower in patients with 25(OH) vitamin D level ≥20 ng/ml on day 7 of hospitalization. The duration of MV, lengths of TICU and hospital stays, and nosocomial infection rate were significantly lower in patients with increased concentrations compared with those with decreased concentrations on day 7 of hospitalization, but the mortality rate did not differ significantly.

CONCLUSIONS

The 25(OH) vitamin D level measured within 24 hours after TICU admission was unrelated to clinical outcomes in critically ill patients with traumatic injuries. However, patients with increased 25(OH) vitamin D level after 7 days of hospitalization had better clinical outcomes than those with decreased levels.

摘要

背景

本研究调查了韩国重症创伤患者中25-羟基维生素D(25(OH)维生素D)缺乏的患病率及其影响。

方法

这项前瞻性观察队列研究评估了2018年1月至12月期间入住庆北国立大学医院创伤重症监护病房(TICU)的连续创伤患者的25(OH)维生素D状态。我们分析了25(OH)维生素D缺乏的患病率及其对临床结局的影响。

结果

在TICU入院24小时内,25(OH)维生素D<20 ng/ml的患者与25(OH)维生素D≥20 ng/ml的患者在机械通气(MV)持续时间、TICU和住院时间、医院感染率和死亡率方面无显著差异。在住院第7天,25(OH)维生素D水平≥20 ng/ml的患者MV持续时间、TICU和住院时间较短,医院感染率较低。与住院第7天浓度降低的患者相比,浓度升高的患者MV持续时间、TICU和住院时间以及医院感染率显著降低,但死亡率无显著差异。

结论

TICU入院后24小时内测得的25(OH)维生素D水平与重症创伤患者的临床结局无关。然而,住院7天后25(OH)维生素D水平升高的患者比水平降低的患者临床结局更好。

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