title: Increased Vitamin B12 levels are associated with mortality in critically ill medical patients.
abstract: OBJECTIVE
  We describe an observational study in critically ill medical patients showing the association between serum Vitamin B12 levels measured on or near admission and the outcome in these patients.
  
  
  METHODS
  We used the database of patients admitted to the Medical Intensive Care Unit (MICU) at the Hadassah-Hebrew University Medical Center in Jerusalem, Israel, to analyze associations between patient demographics, background, diagnoses and serum Vitamin B12 levels with hospital and 90 day outcomes.
  
  
  RESULTS
  Higher mean Vitamin B12 levels were found in patients who did not survive their hospital stay (1719 pg/ml vs 1003 pg/ml, p < 0.01). Those who had died by 90 days after admission to the MICU also had higher Vitamin B12 levels than survivors (1593 pg/ml vs 990 pg/ml). Regression analysis showed that elevated Vitamin B12 levels were associated with increased 90 day mortality, even after controlling for other variables. Survival analysis also showed an increased mortality rate in patients with Vitamin B12 levels over 900 pg/ml (p < 0.0002).
  
  
  CONCLUSIONS
  Our data show that high serum Vitamin B12 levels are associated with increased mortality in critically ill medical patients. We suggest that Vitamin B12 levels should be included in the work-up of all medical intensive care patients, particularly those with a chronic health history and increased severity of illness.
authors: Medical Intensive Care Unit, Hadassah-Hebrew University Medical Center, Ein Karem, Jerusalem 91120, Israel. sigals@hadassah.org.il
authors: S
authors: S
authors: Sviri
authors: R
authors: R
authors: Khalaila
authors: S
authors: S
authors: Daher
authors: A
authors: A
authors: Bayya
authors: D M
authors: DM
authors: Linton
authors: I
authors: I
authors: Stav
authors: P V
authors: PV
authors: van Heerden
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007557:Israel; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D014805:Vitamin B 12