Correlation of Vitamin D Deficiency with Predictors of Mortality in Critically Ill Children at a Tertiary Care Centre in North India—A Prospective, Observational Study

Abstract

This study was conducted to assess the relationship of vitamin D deficiency (VDD) with various demographic characteristics, laboratory parameters, and predictors of mortality. This prospective observational study was performed at pediatric intensive care unit (PICU) of a tertiary care hospital situated in north India. A total of 125 children admitted in PICU with age from 2 months to 14 years were analyzed. The subjects were classified as Vitamin D deficient (≤20 ng/mL) and nondeficient (>20 ng/mL). The relationship between VDD and predictors of mortality were analyzed using correlation and multivariate analysis. Respiratory system (40%) was most commonly involved. VDD was seen in 72% of the patients. There was statistically significant correlation of VDD with age (p = 0.019), season (p = 0.018), height (p = 0.005), and weight (p = 0.003). On multivariate analysis factors associated with VDD were age (odds ratio [OR] = 1.01, 95% confidence interval [CI] 1.00–1.03, p = 0.006), season (OR = 3.98, 95% CI 1.09–14.50, p = 0.036). VDD was also correlated to bacteriuria (p = 0.033), cardiovascular sequential sepsis-related organ failure assessment score (CV-SOFA score) (p = 0.001), and mechanical ventilation (p = 0.043). On multivariate analysis, factors associated with VDD were bacteriuria (OR = 4.88, 95% CI 1.04–22.89, p = 0.04), mechanical ventilation requirement (OR = 2.95, 95% CI 1.12–7.85, p = 0.029), and CV-SOFA score (OR = 2.33, 95% CI 1.14–4.76, p = 0.021). Median (interquartile range) duration of PICU stay in VDD patients was (3–7) days while in nondeficient patients it was (2–6) days (p = 0.107). VDD was a significant risk factor for the need of mechanical ventilation, bacteriuria, and mortality among patients in our cohort.

Keywords

vitamin D deficiency - PRISM III score - CV-SOFA score - mechanical ventilation - mortality - bacteriuria

Authors' Contributions

G.K. and G.G. designed the study. A.K. and S.B. drafted the article and did the statistical analysis. S.B. helped in acquisition of data. J.S., S.R., and J.K.S. helped in preparing the draft and revising it. All the authors approved the final version of study.

Publikationsverlauf

Eingereicht: 13. August 2020

Angenommen: 24. September 2020

Artikel online veröffentlicht:
23. Dezember 2020

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