Khushbakht Arbab, Hafsa Majid, Lena Jafri, Aysha Habib Khan, Madiha Hashmi.
Vitamin D deficiency in critically ill patients: a single center cross-sectional study.
Pak Armed Forces Med J Jan ;70(3):765-69.

Objective: To assess mangitude of vitamin D deficiency and its association with mortality in intensive care unit (ICU). Study Design: Prospective observational study. Place and Duration of Study: Aga Khan University, Karachi, from 2016 to 2017. Methodology: All consecutive patients admitted to medical/surgical intensive care unit in a tertiary care hospital, age between 18 to 70 years were included. Vitamin D level was obtained on first day of admission. Demographic and biochemical variables were recorded. Vitamin D deficiency was defined as 25 (OH) D<20 ng/dL. Data was analyzed by SPSS version 21. Results: A total of 178 patients were included during the study period; 116 (65%) were males and median age was 48 years (64-31). Median 25 (OH) D, ionized calcium and phosphate levels were 8.5 ng/dL (21.9-3.8), 4.32 ng/dL (4.6-4.1), and 3.2 ng/dL (4.2-2.2) respectively. Vitamin D deficiency was observed in 130 (73%) patients and only 27 (15.2%) had optimal level of vitamin D. Vitamin D deficient patients were comparatively younger with median age of 42.5 vs. 60 years (p-value=0.004). Vitamin D levels poorly correlated with ionized calcium and phosphate levels (0.026 (p-value=0.733) and 0.039 (p-value=0.601). No significant association was found between vitamin D deficiency and mortality with p-value of 0.796. Conclusion: Majority of the patients admitted to intensive care unit were vitamin D deficient. Deficiency was more prevalent in younger patients. These findings highlight the need for consideration of vitamin D status and supplementation as it plays a vital role in different physiological processes in patients in the intensive care unit.

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