663 Effect of Admission Vitamin D Levels on Outcomes in Pediatric Burn Patients

Abstract

Abstract Introduction The effect of vitamin D levels on clinical outcomes has been studied in critically ill non-burn patients and adult burn patients. Low vitamin D levels predicted sepsis and were associated with in-hospital mortality in critically ill non-burn patients. Vitamin D deficiency and insufficiency in adult burn patients correlated with higher rates of complications and longer ICU and hospital length of stay (LOS). Vitamin D levels in pediatric patients have been studied during the post-burn period, showing that low vitamin D levels post-burn may play a role in post-burn osteopenia. However, the effects of admission vitamin D levels on outcomes have not been evaluated in the pediatric burn population. Methods This is a retrospective study of pediatric burn patients admitted to an American Burn Association verified burn center over a 3-year period. Patients were included if they were under the age of 18 years and had a vitamin D level measured within 7 days of admission. Vitamin D deficiency was defined as vitamin D level less than 12 ng/mL; insufficiency as vitamin D level 12–20 ng/mL; sufficiency greater than 20 ng/mL. Basic demographics were collected. Outcome data collected included infection, graft loss, renal failure requiring renal replacement therapy, LOS, number of days requiring the ventilator, and need for vasopressors. Univariate and multivariate analyses were performed using SPSS 25.0. P < 0.05 was considered significant. Results A total of 249 pediatric patients were admitted during the study period. Of those, 38 patients had vitamin D levels measured within the first 7 days of admission and were included in the study. No patients were vitamin D deficient, and 7 (18%) patients were vitamin D insufficient. No significant differences were observed between patients who were vitamin D sufficient or insufficient with regards to sex, race, or mechanism of burn injury. Patients who were vitamin D insufficient had a longer LOS (15 days vs. 3.34 days; p = 0.023), a larger total body surface area burn size (16.75% vs. 7.23%; p = 0.027), and required more surgeries (1.14 vs. 0.06; p = 0.037). After adjustment for age and gender, higher vitamin D levels were associated with an increased chance of not having surgery (OR = 1.29, 95%CI[1.06–1.58]; p = 0.013). Conclusions Despite its retrospective nature and small sample size, our study suggests that pediatric patients who present with vitamin D insufficiency may be at risk for increased LOS and need for surgery. Applicability of Research to Practice Larger studies are warranted to identify outcomes affected by low vitamin D levels on admission as well as socioeconomic factors, such poverty level and food insecurity, that may affect vitamin D levels on admission.