title: Vitamin D deficiency is associated with increased mortality in critically ill patients especially in those requiring ventilatory support.
abstract: BACKGROUND
  Vitamin D (VitD) classically recognized for its role in the musculoskeletal system, has been implicated in myriad of conditions such as diabetes, immune dysfunction, cancers, heart disease, metabolic syndrome, etc. We studied the role of VitD in acute care setting and its correlation with mortality.
  
  
  METHODS
  A total of 85 consecutive consenting patients admitted in medical intensive care unit of tertiary care hospital who fulfilled the inclusion criteria were included. All patients were evaluated clinically, and blood samples were collected for hemogram, biochemical investigations including serum calcium, phosphorus, alkaline phosphatase, magnesium, along with 25(OH) VitD, 1,25(OH) VitD and intact parathormone levels. Simplified acute physiology score (SAPS II) was calculated for all patients.
  
  
  RESULTS
  VitD was deficient (<30 ng/ml) in 27 patients (32%). The overall mortality was more in VitD deficient group as compared to VitD sufficient group (74 vs. 41%; P < 0.05). The actual mortality in VitD deficient group was higher than the mortality predicted by SAPS II score (50 vs. 74%; P < 0.0507). VitD deficiency was also associated with more mortality among those requiring ventilator support (95% vs. 40%; P < 0.05) as well as with higher blood glucose (124.5 ± 29.7 vs. 94.8 ± 19.8: P < 0.01) levels.
  
  
  CONCLUSIONS
  VitD deficiency was associated with increased mortality, poor ventilator outcomes, and increased blood glucose in critically ill patients.
authors.affiliation: Department of Endocrinology, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Ameya
authors.initials: A
authors.lastname: Joshi
authors.affiliation: Department of Medicine, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Bhadade
authors.affiliation: Department of Endocrinology, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Premlata K
authors.initials: PK
authors.lastname: Varthakavi
authors.affiliation: Department of Medicine, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Rosmarie
authors.initials: R
authors.lastname: DeSouza
authors.affiliation: Department of Endocrinology, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Nikhil M
authors.initials: NM
authors.lastname: Bhagwat
authors.affiliation: Department of Endocrinology, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Manoj D
authors.initials: MD
authors.lastname: Chadha
keywords: Blood glucose; mortality; vitamin D