Abstract
Objective
The study objective was to examine the association between pre-hospital serum vitamin
D concentration and mortality after hospitalization.
Methods
We performed a retrospective cohort study in 2 tertiary hospitals in Boston, Mass,
on 23,603 patients aged ≥18 years in whom 25(OH)D was measured before hospitalization
between 1993 and 2010. The main outcome measures were all-cause mortality by day 30
post-hospital admission, in-hospital mortality, and community-acquired bloodstream
infection.
Results
Compared with patients with pre-hospital 25(OH)D ≥30 ng/mL, patients with pre-hospital
25(OH)D ≤15 ng/mL or 15 to 30 ng/mL have higher odds of mortality 30 days after hospital
admission. After adjustment for age, gender, race, Deyo-Charlson index, season, type
(surgical vs medical), creatinine, blood urea nitrogen, hematocrit, and time between
25(OH)D draw and hospital admission, the adjusted odds ratio (OR) of 30-day mortality
in patients with 25(OH)D ≤15 ng/mL is 1.45 (95% confidence interval [CI], 1.21-1.74;
P<.0001) and the adjusted OR of 30-day mortality in patients with 25(OH)D 15 to 30 ng/mL
is 1.30 (95% CI, 1.10-1.54; P = .003) both compared with patients with pre-hospital 25(OH)D ≥30 ng/mL. In a subgroup
analysis of patients who had blood cultures drawn (n = 5628), pre-hospital serum 25(OH)D
≤15 ng/mL was associated with increased odds of community-acquired bloodstream infection
(adjusted OR, 1.29; 95% CI, 1.06-1.57; P = .01) relative to patients with 25(OH)D ≥30 ng/mL.
Conclusions
Analysis of 23,603 hospitalized patients identified both 25(OH)D ≤15 ng/mL and 25(OH)D
15 to 30 ng/mL before hospital admission as associated with the odds of all-cause
patient mortality at 30 days after hospitalization. In addition, pre-hospital serum
25(OH)D ≤15 ng/mL is significantly associated with the odds of community-acquired
bloodstream infection.
Keywords
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Article Info
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
