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Vitamin D Status and Long-Term Mortality in Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort.

Holter JC, Ueland T, Norseth J, Brunborg C, Frøland SS, Husebye E, Aukrust P, Heggelund L - PLoS ONE (2016)

Bottom Line: We examined the prevalence of vitamin D deficiency and inadequacy and their effect on long-term mortality in hospitalized adults with CAP.After adjusting for confounders (age, chronic obstructive pulmonary disease, immunocompromization and season), vitamin D deficiency, but not inadequacy, was significantly associated with higher mortality compared to patients with sufficiency (HR 1.91, 95% CI 1.06-3.45; P = .031).The results of this study also suggest that vitamin D deficiency is associated with an increased risk of mortality way beyond the short-term in these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway.

ABSTRACT

Background: Low vitamin D status has been associated with short-term (30-day) mortality in hospitalized adults with community-acquired pneumonia (CAP). Data on its prevalence in these patients are scarce, and impact on long-term prognosis is unknown. We examined the prevalence of vitamin D deficiency and inadequacy and their effect on long-term mortality in hospitalized adults with CAP.

Methods: Secondary follow-up analysis of data from a prospectively recruited (January 2008-January 2011) well-defined cohort of 241 hospital survivors of CAP (Norway, latitude 60°N). Serum 25-hydroxyvitamin D levels, demographic, clinical, and laboratory data were measured within 48 hours of admission. The etiology of CAP was established in 63% of patients through extensive microbiological investigations. Mortality data were obtained from the national Cause of Death Registry. Explanatory strategy and Cox regression models were used to explore the association between vitamin D status and all-cause mortality.

Results: Median age was 66 years. Eighty-seven (36%) patients were vitamin D deficient (<30 nmol/L), 81 (34%) were inadequate (30-49 nmol/L), and 73 (30%) were sufficient (≥50 nmol/L). Seventy-two patients died over a median of 1839 days (range 1-2520 days), corresponding to cumulative 5-year survival rates of 66.2% (95% CI 56.2-76.2%), 77.0% (67.6-86.4%), and 77.8% (67.8-87.8%) for vitamin D deficient, inadequate, and sufficient patients, respectively. After adjusting for confounders (age, chronic obstructive pulmonary disease, immunocompromization and season), vitamin D deficiency, but not inadequacy, was significantly associated with higher mortality compared to patients with sufficiency (HR 1.91, 95% CI 1.06-3.45; P = .031).

Conclusions: There is a high prevalence of vitamin D deficiency and inadequacy among hospitalized adults with CAP. The results of this study also suggest that vitamin D deficiency is associated with an increased risk of mortality way beyond the short-term in these patients.

No MeSH data available.


Related in: MedlinePlus

The prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D <30 nmol/L) and inadequacy (30–49 nmol) throughout the meteorological seasons.The numbers above the bars indicate the number of patients within the related vitamin D category (P = .021).
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pone.0158536.g001: The prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D <30 nmol/L) and inadequacy (30–49 nmol) throughout the meteorological seasons.The numbers above the bars indicate the number of patients within the related vitamin D category (P = .021).

Mentions: The prevalence of vitamin D deficiency and inadequacy per season is shown in Fig 1. Median 25OHD levels were lowest in patients presenting during winter (December through February; n = 68, 30.7 nmol/L [25th–75th percentile 19.7–44.2 nmol/L]) and highest in patients presenting in the summer (June through August; n = 55, 47.0 nmol/L [34.0–60.1 nmol/L]).


Vitamin D Status and Long-Term Mortality in Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort.

Holter JC, Ueland T, Norseth J, Brunborg C, Frøland SS, Husebye E, Aukrust P, Heggelund L - PLoS ONE (2016)

The prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D <30 nmol/L) and inadequacy (30–49 nmol) throughout the meteorological seasons.The numbers above the bars indicate the number of patients within the related vitamin D category (P = .021).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4930204&req=5

pone.0158536.g001: The prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D <30 nmol/L) and inadequacy (30–49 nmol) throughout the meteorological seasons.The numbers above the bars indicate the number of patients within the related vitamin D category (P = .021).
Mentions: The prevalence of vitamin D deficiency and inadequacy per season is shown in Fig 1. Median 25OHD levels were lowest in patients presenting during winter (December through February; n = 68, 30.7 nmol/L [25th–75th percentile 19.7–44.2 nmol/L]) and highest in patients presenting in the summer (June through August; n = 55, 47.0 nmol/L [34.0–60.1 nmol/L]).

Bottom Line: We examined the prevalence of vitamin D deficiency and inadequacy and their effect on long-term mortality in hospitalized adults with CAP.After adjusting for confounders (age, chronic obstructive pulmonary disease, immunocompromization and season), vitamin D deficiency, but not inadequacy, was significantly associated with higher mortality compared to patients with sufficiency (HR 1.91, 95% CI 1.06-3.45; P = .031).The results of this study also suggest that vitamin D deficiency is associated with an increased risk of mortality way beyond the short-term in these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway.

ABSTRACT

Background: Low vitamin D status has been associated with short-term (30-day) mortality in hospitalized adults with community-acquired pneumonia (CAP). Data on its prevalence in these patients are scarce, and impact on long-term prognosis is unknown. We examined the prevalence of vitamin D deficiency and inadequacy and their effect on long-term mortality in hospitalized adults with CAP.

Methods: Secondary follow-up analysis of data from a prospectively recruited (January 2008-January 2011) well-defined cohort of 241 hospital survivors of CAP (Norway, latitude 60°N). Serum 25-hydroxyvitamin D levels, demographic, clinical, and laboratory data were measured within 48 hours of admission. The etiology of CAP was established in 63% of patients through extensive microbiological investigations. Mortality data were obtained from the national Cause of Death Registry. Explanatory strategy and Cox regression models were used to explore the association between vitamin D status and all-cause mortality.

Results: Median age was 66 years. Eighty-seven (36%) patients were vitamin D deficient (<30 nmol/L), 81 (34%) were inadequate (30-49 nmol/L), and 73 (30%) were sufficient (≥50 nmol/L). Seventy-two patients died over a median of 1839 days (range 1-2520 days), corresponding to cumulative 5-year survival rates of 66.2% (95% CI 56.2-76.2%), 77.0% (67.6-86.4%), and 77.8% (67.8-87.8%) for vitamin D deficient, inadequate, and sufficient patients, respectively. After adjusting for confounders (age, chronic obstructive pulmonary disease, immunocompromization and season), vitamin D deficiency, but not inadequacy, was significantly associated with higher mortality compared to patients with sufficiency (HR 1.91, 95% CI 1.06-3.45; P = .031).

Conclusions: There is a high prevalence of vitamin D deficiency and inadequacy among hospitalized adults with CAP. The results of this study also suggest that vitamin D deficiency is associated with an increased risk of mortality way beyond the short-term in these patients.

No MeSH data available.


Related in: MedlinePlus