title: Vitamin D and delirium in critically ill patients: a preliminary investigation.
abstract: OBJECTIVE
  The pathophysiology of delirium in critical illness is unclear. 25-OH vitamin D (25-OHD) has neuroprotective properties but a relationship between serum 25-OHD and delirium has not been examined. We tested the hypothesis that low serum 25-OHD is associated with delirium during critical illness.
  
  
  METHODS
  In a prospective cohort of 120 medical intensive care unit (ICU) patients, blood was collected within 24 hours of ICU admission for measurement of 25-OHD. Delirium was identified once daily using the Confusion Assessment Method for the ICU. Multivariable logistic regression was used to analyze the association between 25-OHD and delirium assessed the same day and the subsequent day after 25-OHD measurement, with adjustments for age and severity of illness.
  
  
  RESULTS
  Median age was 52 years (interquartile range, 40-62), and Acute Physiology and Chronic Health Evaluation II was 23 (interquartile range, 17-30). Thirty-seven patients (41%) were delirious on the day of 25-OHD measurement. 25-OHD levels were not associated with delirium on the day of 25-OHD measurement (odds ratio, 1.01; 95% confidence interval, 0.98-1.02) or on the day after measurement (odds ratio, 1.01; 95% confidence interval, 0.99-1.03).
  
  
  CONCLUSIONS
  This pilot study suggests that 25-OHD levels measured early during critical illness are not important determinants of delirium risk. Since 25-OHD levels can fluctuate during critical illness, a study of daily serial measurements of 25-OHD levels and their relationship to delirium during the duration of critical illness may yield different results.
authors.affiliation: Department of Rehabilitation and Aged Care Unit, Ancelle Hospital, 26100 Cremona, Italy. morandi.alessandro@gmail.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Morandi
authors.forename: Nicolas
authors.initials: N
authors.lastname: Barnett
authors.forename: Russel R
authors.initials: RR
authors.lastname: Miller
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Girard
authors.forename: Pratik P
authors.initials: PP
authors.lastname: Pandharipande
authors.forename: Eugene W
authors.initials: EW
authors.lastname: Ely
authors.forename: L B
authors.initials: LB
authors.lastname: Ware
mesh_terms: D055371:Acute Lung Injury / Q000175:diagnosis; D000328:Adult; D000367:Age Factors; D016638:Critical Illness; D003693:Delirium / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014808:Vitamin D Deficiency / Q000097:blood / Q000503:physiopathology*