The Effects of Initial cortisol levels and Vitamin D on Mortality and Hospital Infection Development in Geriatric Patients at Intensive Care Unit

Abstract

Introduction: Vitamin D deficiency is a common problem throughout the world. Also vitamin D deficiency has been reported in up to 82% of patients in intensive care unit (ICU). In addition, corticosteroid insufficiency is a common problem in ICU patients. In this study, we investigated the effects of initial cortisol and vitamin D levels on mortality, hospital infection development and intubation status in geriatric ICU patients. Methods: This study was conducted in a tertiary ICU. In a one-year period, 117 consecutive ICU patients older than 65 years of age were evaluated retrospectively. Looking at the first with Vitamin D and cortisol levels of the patients were collected in the first 24 hours of hospitalization. At follow up period, relationship between these data’s and mortality, hospital infection, and intubation conditions were evaluated. Results: Initial Vitamin D, the morning cortisol, and albumin levels were found to be significantly lower (respectively; p <0.001, p <0.001 and p <0.001), and lactate levels were found to be significantly higher (p <0.001) in patients who died in ICU than alive patients. Development rate of hospital-acquired infection was found to be significantly higher (p = 0.025) in patients with low vitamin D levels than alive patients. Vitamin D and cortisol levels were found to be lower and lactate levels were found to be higher (respectively: p <0.001, p = 0.004, p = 0.035) in intubated patients than alive patients. Conclusion: In geriatric patients, relationship between initial vitamin D and cortisol levels and mortality, hospital infection and intubation conditions were evaluated in our study for the first time. The low level of vitamin D is seen as an important risk factor for the mortality, development of hospital-acquired infections and intubation. Also it is determined that the low cortisol creates a negative situation in terms of mortality and intubation.