Relationship of vitamin D in children with sepsis/severe sepsis and outcomes in PICU

Abstract

Objective To determine the vitamin D status in children with sepsis/severe sepsis in pediatric intensive care unit (PICU) in order to explor the association between vitamin D status and clinical outcomes, in turn to provide evidence for optimizing nutrition support. Methods It was a prospective, observational, multi-center study, carried out in patients with sepsis/severe sepsis from March 1, 2013, to March 30, 2014, in the PICUs of three tertiary-care children's hospitals. Total serum 25-hydroxy vitamin D [25(OH)D] was measured by using an enzyme-linked immunosorbent assay at admission.The association of vitamin D status at admission with length of PICU length of stay, total hospital stay, in-hospital mortality, 28-days mortality and costs were analyzed. Results A total of 194 patients includng 117 boys (60.3%) and 77 girls (39.7%) were enrolled. There were 96 patients with sepsis and 98 with severe sepsis. The mortality on discharge and 28 days were 6.7% and 24.2% respectively. The median vitamin D level was 9.79 ng/mL (5.32, 18.46) at admission.Of them 77.8% (151/194) had vitamin D deficiency and 50.5% (98/194) had severe vitamin D deficiency. Patients with severe vitamin D deficiency, had higher mortality on discharge (P=0.011). Vitamin D status had no significant correlations with 28 days mortality, length of PICU stay, total hospital stay and costs. Conclusions More than three-quarters (77.8%) of children with sepsis/severe sepsis in PICUs had Vitamin D deficiency. Patients with severe vitamin D deficiency at admission had higher risk of mortality at discharge. Key words: Sepsis; Severe sepsis, Children; Vitamin D Deficiency; Outcomes