Vitamin D deficiency at pediatric intensive care admission

J Pediatr (Rio J). 2014 Mar-Apr;90(2):135-42. doi: 10.1016/j.jped.2013.08.004. Epub 2013 Oct 30.

Abstract

Objective: to assess whether 25hydroxivitaminD or 25(OH)vitD deficiency has a high prevalence at pediatric intensive care unit (PICU) admission, and whether it is associated with increased prediction of mortality risk scores.

Method: prospective observational study comparing 25(OH)vitD levels measured in 156 patients during the 12 hours after critical care admission with the 25(OH)vitD levels of 289 healthy children. 25(OH)vitD levels were also compared between PICU patients with pediatric risk of mortality III (PRISM III) or pediatric index of mortality 2 (PIM 2) > p75 [(group A; n = 33) vs. the others (group B; n = 123)]. Vitamin D deficiency was defined as < 20 ng/mL levels.

Results: median (p25-p75) 25(OH)vitD level was 26.0 ng/mL (19.2-35.8) in PICU patients vs. 30.5 ng/mL (23.2-38.6) in healthy children (p = 0.007). The prevalence of 25(OH)vitD < 20 ng/mL was 29.5% (95% CI: 22.0-37.0) vs. 15.6% (95% CI: 12.2-20.0) (p = 0.01). Pediatric intensive care patients presented an odds ratio (OR) for hypovitaminosis D of 2.26 (CI 95%: 1.41-3.61). 25(OH)vitD levels were 25.4 ng/mL (CI 95%: 15.5-36.0) in group A vs. 26.6 ng/mL (CI 95%: 19.3-35.5) in group B (p = 0.800).

Conclusions: hypovitaminosis D incidence was high in PICU patients. Hypovitaminosis D was not associated with higher prediction of risk mortality scores.

Keywords: 25 hydroxivitamin D; 25‐hidroxivitamina D; Crianças gravemente doentes; Critical care; Critically‐ill children; Indicadores prognósticos; Mortality risk; Prognostic markers; Risco de mortalidade; Terapia intensiva.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Child
  • Child, Preschool
  • Critical Care
  • Female
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Infant
  • Intensive Care Units, Pediatric / statistics & numerical data*
  • Male
  • Prevalence
  • Prospective Studies
  • Risk
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / mortality

Substances

  • Biomarkers
  • Vitamin D
  • 25-hydroxyvitamin D