Abstract
Background
Vitamin D is an important immune modulator and is associated with susceptibility to
infection. However, past studies have reported inconsistent results regarding the
association between vitamin D deficiency and mortality in patients with sepsis, and
early-stage data regarding septic shock are limited. This study aimed to determine
the relationship between vitamin D deficiency on admission to the emergency department
(ED) and mortality in patients with septic shock.
Methods
We analyzed prospectively collected data on adult patients with septic shock who were
treated with protocol-driven resuscitation bundle therapy in the ED between September
2019 and February 2021. Septic shock was defined by the sepsis-3 definition and vitamin
D deficiency was defined as a 25-hydroxyvitamin D <20 ng/ml. The primary outcome was
30-day mortality.
Results
A total of 302 patients were included, 236 (78.1%) patients had vitamin D deficiency;
it was significantly higher in non-survivors than in survivors (89.3% vs. 73.9%, P = 0.004). Mortality was higher in vitamin D deficient patients than in non-deficient
patients (31.8% vs. 13.6%, P = 0.004). In multivariate analysis, vitamin D deficiency (odds ratio [OR], 2.43;
95 % confidence interval [CI], 1.03–5.74), hyperlactatemia (OR, 3.65; 95 % CI, 1.95–6.83),
Sequential Organ Failure Assessment scores (OR, 1.22; 95% CI, 1.09–1.36), and albumin
levels (OR, 0.39; 95% CI, 0.21–0.73) were significantly associated with 30-day mortality.
Conclusions
Vitamin D deficiency was prevalent in patients with septic shock visiting the ED and
was associated with mortality.
Key Indexing Terms
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Article info
Publication history
Published online: October 17, 2022
Accepted:
October 13,
2022
Received:
February 15,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
