Serum Vitamin D Level in Patients with Sepsis and its Correlation with Sequential Organ Failure Assessment Score: A Cross-sectional Study

Abstract

Introduction: Sepsis is a leading cause of morbidity and mortality worldwide, and the Sequential Organ Failure Assessment (SOFA) score is used as a key criterion in diagnosing the sepsis syndrome. Recent studies have also suggested that vitamin D is an important mediator in the immune system and plays an inhibitory role in sepsis. Aim: To assess serum vitamin D levels in patients with sepsis and to investigate the correlation between vitamin D levels and the SOFA score, as well as the outcomes of sepsis. Materials and Methods: This was a hospital-based cross-sectional study carried out on 91 patients diagnosed with sepsis. The SOFA score was calculated within 24 hours of admission and again at 72 hours; however, only the SOFA score obtained on admission (within 24 hours) was used to assess disease severity and to compare with vitamin D levels. Vitamin D assessment was conducted using a competitive immunoassay in the VITROS 5600 fully automated integrated assay system. Pearson’s correlation (r) was used to measure the association between variables. Results: The mean age of the study population was 57.34±16.55 years, with a male to female ratio of 1.17:1. A significant increase in vitamin D deficiency was noted in patients with a SOFA score above 10. There was a negative correlation between serum vitamin D levels and the SOFA score within 24 hours after admission, which was statistically significant (p-value <0.001, r-value -0.420). In the vitamin D deficient group, 65.7% of patients died, demonstrating a significant negative association between vitamin D levels and mortality (p-value <0.001). Conclusion: This study has shown that lower levels of vitamin D are associated with greater severity of sepsis upon admission. Additionally, lower vitamin D levels are linked to a higher mortality rate and poor outcomes. However, larger-scale, intervention-based trials of supplementary vitamin D therapy in the management of sepsis are required to strengthen the evidence of the correlation between these two variables.

Keywords

• cholecalciferol
• sequential organ failure assessment score
• septicaemia