Impact of pre-operative vitamin D deficiency on post-operative outcomes in adult cardiac surgery

Abstract

Pleiotropic effects of Vitamin D (Vit D) on various cell types and causative association in the epidemiology of cardiovascular diseases is known for ages. Observational studies have successfully linked Vit D deficient states to critical illness and increased ICU morbidity and mortality. The role of preoperative Vit D deficiency on postoperative outcome in cardiac surgery patients is a new horizon for research. A prospective observational cohort study was planned to assess impact of pre-operative Vit D deficiency on post-operative cardiac outcomes in adult patients undergoing cardiac surgery, Vit D level was assessed in the preoperative period and divided into group I Vit D deficient (<20ng/ml) and group II Vit D sufficient (>20ng/ml). Primary outcome was to study the occurrence of myocardial infarction, arrhythmia, low cardiac output syndrome (LCOS) and inotropic requirement. Secondary outcomes were duration of mechanical ventilation, ICU length of stay, hospital stay and mortality. Vit D deficiency was associated with increased incidence of arrhythmia (p=0.019), LCOS (0.003) and high inotropic requirements (p=0.001) with no relation to occurrence of MI (p=0.422) and mechanical support (p= 0.114) as compared to the sufficient group. Vit D deficiency was also associated with increased duration of mechanical ventilation (p=0.008), ICU (p=0.001) and hospital stay (p=0.00) as compared to other group. Vitamin D deficiency was associated with increased occurrence of arrhythmia, LCOS and high inotropic requirements. ICU morbidity in the form of increased duration of mechanical ventilation, ICU and hospital stay was increased in patients with Vit D deficiency.