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Abstract

Introduction: Prior studies have shown conflicting evidence about possible association between 25-OH Vitamin D (Vit D) deficiency and increased all cause mortality in critically ill patients. Due to inconclusive results, we did a meta-analysis of available studies. The aim of this study is to summarize available evidence on the association between Vit D and all cause mortality in critically ill, evaluating its magnitude and direction in a meta-analysis. Methods: Systematic search was carried out on OvidSP, PubMed and Medline databases up to March 2013 for published papers. There was no language restriction to our search criteria. Search was carried out with terms including 'Vitamin D deficiency' and 'Mortality in critically ill' or 'ICU mortality'. The eligible studies from search results were reviewed for additional reference studies on the subject. Initial analysis of all included studies showed evidence of heterogeneity; therefore, all analyses were done using the random effects model. Publication bias was assessed using the Begg's and Mazumdar test and Egger's tests and visual inspection of funnel plot. All analyses were performed using Comprehensive Meta Analysis software. Results: We identified six studies which included a total of 4534 patients out of which 1793 patients were Vitamin D deficient. 48% of the study participants were males. Overall Vit D deficiency prevalence was 39.55%. On initial analysis, all cause mortality was found to be 1.46 fold higher in Vit D deficiency patients (95% CI 1.01-2.11, p<0.05). Egger's regression analysis and visual inspection of funnel plot showed evidence of publication bias. Duval and Tweedie's trim and fill was applied to calculate the adjusted RR which was found to be 1.39 (95% CI 0.96-2.00). Conclusions: Based on current epidemiological evidence, our study showed no significant association between Vitamin D (25-OH) deficiency and all cause mortality in critically ill patients.