The prevalence of vitamin D deficiency and its relationship with disease severity in an urban pediatric critical care unit.
OBJECTIVE
To evaluate the prevalence of vitamin D deficiency among patients admitted to a Pediatric Critical Care Unit (PCCU) in an urban children's hospital, and to assess if there is a correlation between vitamin D level and disease severity.


METHODS
Patients (216) between the ages of 1-21 years admitted to the PCCU in a children's hospital, excluding those readmitted with a previous vitamin D level, were enrolled. Serum 25-OH vitamin D levels were measured in all patients within 24 h of admission to the PCCU. The severity of patient illness was assessed by the Pediatric Logistic Organ Dysfunction (PELOD) score determined on admission.


RESULTS
Vitamin D deficiency was found in 28% of patients and vitamin D insufficiency was found in 47% of patients. Adolescent age group, female gender, Black race, winter season, and increasing BMI were determined to be risk factors associated with vitamin D deficiency. No significant correlation was found between vitamin D level and PELOD score (p=0.09). There were six deaths (3%), 5 (83%) of which occurred in patients with low vitamin D levels. Total serum calcium levels correlated with vitamin D (p=0.005) and PELOD score (p=0.001). However, ionized calcium levels did not significantly correlate with vitamin D (p=0.62) or PELOD score (p=0.26).


CONCLUSIONS
Vitamin D deficiency is common in children admitted to an urban inner city PCCU, with 75% of patients having abnormal levels. We did not find a significant correlation between disease severity as measured by PELOD score and vitamin D level in a heterogeneous group of critically ill children. Total serum calcium levels significantly correlated with vitamin D and disease severity in this population. There appears to be an association between vitamin D deficiency and mortality.
M
M
Ayulo
Ch
Ch
Katyal
Ch
Ch
Agarwal
T
T
Sweberg
D
D
Rastogi
M
M
Markowitz
H M
HM
Ushay
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index; D014808:Vitamin D Deficiency / Q000453:epidemiology*; D055815:Young Adult