Predictive capacity of vitamin D and HDL levels alone and in combination for mortality in critically ill patients.

Abstract

INTRODUCTION: Vitamin D and HDL (high density lipoprotein) levels have potential to be used as an early and simple predictor of morbidity and mortality in critically ill patients. The aim of the study was to determine the predictive capacity of vitamin D and HDL levels alone and in combination for mortality in critically ill patients. MATERIALS AND METHODS: Prospective observational study involving 302 patients admitted to an intensive care unit (ICU). Blood samples were obtained within the initial 24 hours of admission to assess vitamin D and HDL levels. Vitamin D levels of >20 ng/ml were considered non-deficient and ≤ 20 ng/mL considered deficient. HDL levels >30 mg/dl were considered normal HDL and <30 mg / dl were considered low HDL. The study collected data on various parameters including the APACHE II score at the ICU admission, SOFA scores throughout the ICU stay, 28-day mortality, as well as the requirement for mechanical ventilation, inotropic support, and renal replacement therapy RESULTS: Of 302 patients, 102 (33.77%) had mortality in 28 days. While analysing the predictive capacity of vitamin D and HDL alone and in combination for mortality at 28 days, the AUC (Area Under the Curve) was 0.667 (95% CI 0.610 TO 0.720), 0.673 (95%CI 0.617 TO 0.725), 0.628 (95% CI 0.571 TO 0.683) respectively. The vitamin D level 12 ng/ml and the HDL level 29 mg/dl were found to have a statistically significant association with mortality. P value <0.001. CONCLUSIONS: The study showed that vitamin D and HDL levels alone and in combination have a significant association with mortality in critically ill patients.

Keywords

• intensive care unit
• high-density lipoprotein
• mortality
• vitamin d