Vitamin D deficiency is highly prevalent in malnourished inpatients and associated with higher mortality: A prospective cohort study
Meret Merker, Aline Amsler, Renata Pereira, Rebekka Bolliger, Pascal Tribolet, Nina Braun, Claus Hoess, Vojtech Pavlicek, Stefan Bilz, Sarah Sigrist, Michael Brändle, Christoph Henzen, Robert Thomann, Jonas Rutishauser, Drahomir Aujesky, Nicolas Rodondi, Jaques Donzé, Zeno Stanga, Beat Mueller & Philipp Schuetz
abstract
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The impact of vitamin D deficiency on the recovery of patients with
malnutrition remains undefined. Our aim was to study the prevalence
of vitamin D deficiency in a well-characterized cohort of patients
with malnutrition and its association with outcomes.Within this
secondary analysis of a randomized controlled trial, we examined the
association of vitamin D deficiency and adverse clinical outcomes
over a follow-up of 180 days in hospitalized patients at risk for
malnutrition. We measured 25-hydroxyvitamin D levels upon admission
and defined Vitamin D deficiency when levels were <50nmol/l. The
primary endpoint was 180-day mortality.The prevalence of vitamin D
deficiency in our cohort of 828 patients was 58.2% (n = 482).
Patients with vitamin D deficiency had increased 180-day mortality
rates from 23.1% to 29.9% (odds ratio 1.42, 95% confidence interval
[CI] 1.03-1.94, P = .03). When adjusting the analysis for
demographics, comorbidities, and randomization, this association
remained significant for the subgroup of patients not receiving
vitamin D treatment (adjusted odds ratio 1.63, 95% CI 1.01-2.62,
P = .04). There was no significantly lower risk for mortality in
the subgroup of vitamin D deficient patients receiving vitamin D
treatment compared to not receiving treatment (adjusted odds ratio
0.74, 95% CI 0.48-1.13, P = .15).Vitamin D deficiency is highly
prevalent in the population of malnourished inpatients and is
negatively associated with long-term mortality particularly when
patients are not receiving vitamin D treatment. Our findings suggest
that malnourished patients might benefit from vitamin D screening
and treatment in case of deficiency.
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citation
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Merker M, Amsler A, Pereira R, Bolliger R, Tribolet P, Braun N,
Hoess C, Pavlicek V, Bilz S, Sigrist S, Brändle M, Henzen C,
Thomann R, Rutishauser J, Aujesky D, Rodondi N, Donzé J, Stanga Z,
Mueller B, Schuetz P. Vitamin D deficiency is highly prevalent in
malnourished inpatients and associated with higher mortality: A
prospective cohort study. Medicine (Baltimore) 2019; 98:e18113.
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type
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journal paper/review (English)
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date of publishing
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11-2019
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journal title
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Medicine (Baltimore) (98/48)
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ISSN electronic
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1536-5964
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pages
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e18113
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PubMed
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31770235
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DOI
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10.1097/MD.0000000000018113
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