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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1485554
This article is part of the Research Topic Infections in the Intensive Care Unit - Volume III View all articles

Vitamin D Supplementation during Intensive Care Unit Stay Is Associated with Improved Outcomes in Critically Ill Patients with Sepsis: A Cohort Study

Provisionally accepted
Caifeng Li Caifeng Li 1*Ke Zhao Ke Zhao 1Qian Ren Qian Ren 2Lin Chen Lin Chen 1Ying Zhang Ying Zhang 1Guolin Wang Guolin Wang 1Keliang Xie Keliang Xie 1
  • 1 Tianjin Medical University General Hospital, Tianjin, China
  • 2 Tianjin Daily, Tianjin, China

The final, formatted version of the article will be published soon.

    Background: Patients 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.We 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.Results: A 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 (defficiency: 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).Conclusions: Vitamin D supplementation may reduce mortality in critically ill patients with sepsis. However, further high-quality prospective studies are still needed to validate these findings.

    Keywords: Critical Illness, Mortality, supplementation, Vitamin D, microbial infection, Sepsis 4

    Received: 24 Aug 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Li, Zhao, Ren, Chen, Zhang, Wang and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Caifeng Li, Tianjin Medical University General Hospital, Tianjin, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.