Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort study
BackgroundPatients with vitamin D deficiency are susceptible to increased microbial infection and increased risk of mortality. However, whether vitamin D supplementation would improve their prognosis remains uncertain.MethodsWe conducted a retrospective cohort study using data from MIMIC-IV database...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2024.1485554/full |
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| author | Caifeng Li Ke Zhao Qian Ren Lin Chen Ying Zhang Guolin Wang Keliang Xie |
| author_facet | Caifeng Li Ke Zhao Qian Ren Lin Chen Ying Zhang Guolin Wang Keliang Xie |
| author_sort | Caifeng Li |
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| description | BackgroundPatients with vitamin D deficiency are susceptible to increased microbial infection and increased risk of mortality. However, whether vitamin D supplementation would improve their prognosis remains uncertain.MethodsWe conducted a retrospective cohort study using data from MIMIC-IV database, a publicly available database containing clinical information on patients admitted to the ICU at Beth Israel Deaconess Medical Center (BIDMC) from 2008 to 2019. Adult patients with sepsis were included in the analysis. The exposure factor was vitamin D supplementation during the ICU stay. The primary outcome was 28-day all-cause mortality. Both propensity score matching (PSM) and stepwise regression analyses were employed to adjust for potential confounders.ResultsA total of 20230 eligible patients were enrolled in the entire unmatched cohort, and 8710 patients were included in the matched cohort. In PSM analysis, the 28-day all-cause mortality rate was 14.04% (250/1780) in the vitamin D group and 22.31% (1546/6930) in the no vitamin D group. Vitamin D supplementation was associated with decreased 28-day all-cause mortality (HR, 0.56; 95% CI, 0.49-0.64; p < 0.001). Subgroup analyses showed consistent benefits regardless of the baseline vitamin D status (deficiency: HR, 0.70; 95% CI, 0.33-1.50; p = 0.36; insufficiency: HR, 0.10; 95% CI, 0.03-0.34; p < 0.001; sufficiency: HR, 0.33; 95% CI, 0.12-0.88; p = 0.03). Additionally, vitamin D supplementation was associated with decreased ICU mortality (OR, 0.37; 95% CI, 0.29-0.48; p < 0.001) and reduced in-hospital mortality (OR, 0.57; 95% CI, 0.48-0.68; p < 0.001). Sensitivity analysis using the unmatched cohort confirmed these findings (HR, 0.57; 95% CI, 0.43-0.76; p < 0.001).ConclusionsVitamin D supplementation may reduce mortality in critically ill patients with sepsis. However, further high-quality prospective studies are still needed to validate these findings. |
| format | Article |
| id | doaj-art-5b228968f2524049acd162e416330d04 |
| institution | Kabale University |
| issn | 2235-2988 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj-art-5b228968f2524049acd162e416330d042025-01-20T05:23:48ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-01-011410.3389/fcimb.2024.14855541485554Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort studyCaifeng Li0Ke Zhao1Qian Ren2Lin Chen3Ying Zhang4Guolin Wang5Keliang Xie6Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of General Surgery, Tianjin Medical University General Hospital, Tianjin, ChinaAdvertising Center, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital Airport Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaBackgroundPatients with vitamin D deficiency are susceptible to increased microbial infection and increased risk of mortality. However, whether vitamin D supplementation would improve their prognosis remains uncertain.MethodsWe conducted a retrospective cohort study using data from MIMIC-IV database, a publicly available database containing clinical information on patients admitted to the ICU at Beth Israel Deaconess Medical Center (BIDMC) from 2008 to 2019. Adult patients with sepsis were included in the analysis. The exposure factor was vitamin D supplementation during the ICU stay. The primary outcome was 28-day all-cause mortality. Both propensity score matching (PSM) and stepwise regression analyses were employed to adjust for potential confounders.ResultsA total of 20230 eligible patients were enrolled in the entire unmatched cohort, and 8710 patients were included in the matched cohort. In PSM analysis, the 28-day all-cause mortality rate was 14.04% (250/1780) in the vitamin D group and 22.31% (1546/6930) in the no vitamin D group. Vitamin D supplementation was associated with decreased 28-day all-cause mortality (HR, 0.56; 95% CI, 0.49-0.64; p < 0.001). Subgroup analyses showed consistent benefits regardless of the baseline vitamin D status (deficiency: HR, 0.70; 95% CI, 0.33-1.50; p = 0.36; insufficiency: HR, 0.10; 95% CI, 0.03-0.34; p < 0.001; sufficiency: HR, 0.33; 95% CI, 0.12-0.88; p = 0.03). Additionally, vitamin D supplementation was associated with decreased ICU mortality (OR, 0.37; 95% CI, 0.29-0.48; p < 0.001) and reduced in-hospital mortality (OR, 0.57; 95% CI, 0.48-0.68; p < 0.001). Sensitivity analysis using the unmatched cohort confirmed these findings (HR, 0.57; 95% CI, 0.43-0.76; p < 0.001).ConclusionsVitamin D supplementation may reduce mortality in critically ill patients with sepsis. However, further high-quality prospective studies are still needed to validate these findings.https://www.frontiersin.org/articles/10.3389/fcimb.2024.1485554/fullcritical illnessmortalitysupplementationvitamin Dmicrobial infectionsepsis |
| spellingShingle | Caifeng Li Ke Zhao Qian Ren Lin Chen Ying Zhang Guolin Wang Keliang Xie Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort study Frontiers in Cellular and Infection Microbiology critical illness mortality supplementation vitamin D microbial infection sepsis |
| title | Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort study |
| title_full | Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort study |
| title_fullStr | Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort study |
| title_full_unstemmed | Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort study |
| title_short | Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort study |
| title_sort | vitamin d supplementation during intensive care unit stay is associated with improved outcomes in critically ill patients with sepsis a cohort study |
| topic | critical illness mortality supplementation vitamin D microbial infection sepsis |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2024.1485554/full |
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