title: Deficiency in 25-hydroxyvitamin D and 30-day mortality in patients with severe sepsis and septic shock.
abstract: BACKGROUND
  Vitamin D has immunomodulating properties.
  
  
  OBJECTIVE
  To determine if vitamin D deficiency within 30 days of admission to the intensive care unit in patients with sepsis might be associated with increased all-cause 30-day mortality.
  
  
  METHODS
  In a retrospective cohort study at a large, tertiary, urban, academic medical center, records of patients who had 25-hydroxyvitamin D levels measured within 30 days of admission for severe sepsis or septic shock from June 2006 to April 2011 were examined. Patients were considered deficient in vitamin D if its serum concentration was 15 ng/mL or less. The primary outcome of interest was 30-day mortality.
  
  
  RESULTS
  Among the 121 patients in the sample, 65 (54%) were vitamin D deficient. Baseline demographics were similar between vitamin D deficient and nondeficient groups, except that the vitamin D deficient group had more African Americans (P = .01). All-cause 30-day mortality was significantly higher in patients deficient in vitamin D (37% vs 20%; P = .04) and remained higher at 90 days (51% vs 25%, P = .005). In multivariate analysis, age (odds ratio, 1.04; 95% CI 1.01-1.07; P = .01) and vitamin D deficiency (odds ratio, 2.7; 95% CI, 1.39-18.8; P = .02) were independently associated with increased 30-day mortality.
  
  
  CONCLUSIONS
  Patients deficient in vitamin D within 30 days of hospital admission for severe sepsis or septic shock may be at increased risk for all-cause 30-day mortality.
authors.affiliation: Megan A. Rech, Todd Hunsaker, and Jennifer Rodriguez are clinical pharmacists, critical care, Department of Pharmacy Services, Henry Ford Hospital, Detroit, Michigan. mrech@lumc.edu.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Rech
authors.affiliation: Megan A. Rech, Todd Hunsaker, and Jennifer Rodriguez are clinical pharmacists, critical care, Department of Pharmacy Services, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Todd
authors.initials: T
authors.lastname: Hunsaker
authors.affiliation: Megan A. Rech, Todd Hunsaker, and Jennifer Rodriguez are clinical pharmacists, critical care, Department of Pharmacy Services, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rodriguez
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002762:Cholecalciferol / Q000627:therapeutic use; D004872:Ergocalciferols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood / Q000401:mortality*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood / Q000401:mortality; D013997:Time Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000208:ethnology / Q000401:mortality*; D014815:Vitamins / Q000627:therapeutic use; D044465:White People
chemical_list: D004872:Ergocalciferols; D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D