title: [Vitamin D deficiency and morbimortality in critically ill paediatric patients].
abstract: OBJECTIVE
  To determine the prevalence and risks factors of vitamin D deficiency, as well as its relationship with morbidity and mortality in a PICU.
  
  
  METHODS
  An observational prospective study in a tertiary children's University Hospital PICU conducted in two phases: i: cohorts study, and ii: prevalence study. The study included 340 critically ill children with ages comprising 6 months to 16 years old.
  
  
  METHODS
  Chronic kidney disease, known parathyroid disorders, and vitamin D supplementation. Total 25-hydroxyvitamin D [25(OH)D] was measured in the first 48hours of admission to a PICU. Parathormone, calcium, phosphate, blood gases, blood count, C-reactive protein, and procalcitonin were also analysed. A record was also made of demographic features, characteristics of the episode, and complications during the PICU stay.
  
  
  RESULTS
  The overall prevalence rate of vitamin D deficiency was 43.8%, with a mean of 22.28 (95% CI 21.15-23.41) ng/ml. Patients with vitamin D deficiency were older (61 vs 47 months, P=.039), had parents with a higher level of academic studies (36.5% vs 20%, P=.016), were admitted more often in winter and spring, had a higher PRISM-III (6.8 vs 5.1, P=.037), a longer PICU stay (3 vs 2 days, P=.001), and higher morbidity (61.1% vs 30.4%, P<001) than the patients with sufficient levels of 25(OH)D. Patients who died had lower levels of 25(OH)D (14±8.81ng/ml versus 22.53±10.53ng/ml, P=.012). Adjusted OR for morbidity was 5.44 (95%CI; 2.5-11.6).
  
  
  CONCLUSIONS
  Vitamin D deficiency is frequent in critically ill children, and it is related to both morbidity and mortality, although it remains unclear whether it is a causal relationship or it is simply a marker of severity in different clinical situations.
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario de Málaga, Málaga, España. Electronic address: patricia.garcia.soler.sspa@juntadeandalucia.es.
authors.forename: Patricia
authors.initials: P
authors.lastname: García-Soler
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario de Málaga, Málaga, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Morales-Martínez
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario de Málaga, Málaga, España.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rosa-Camacho
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario de Málaga, Málaga, España.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Lillo-Muñoz
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario de Málaga, Málaga, España.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Milano-Manso
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009017:Morbidity; D015995:Prevalence; D012307:Risk Factors; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000401:mortality
keywords: Déficit de vitamina D; Morbidity; Morbilidad; Mortalidad; Mortality; Prevalence; Prevalencia; Vitamin D; Vitamin D deficiency; Vitamina D