Prospective association of Serum Vitamin D level with Sepsis-Mortality in Postmenopausal women: results from the WomenÕs Health Initiative
Background: Vitamin D deficiency has been studied in the critically ill, and has been associated with worse morbidity and mortality rates, especially in those admitted with sepsis. Sepsis is a major cause of ICU admissions and accounts for 250,000 deaths per year. Dihydroxyvitamin D can inhibit the production of interleukins, Tumor Necrosis Factor and can also increase the expression of endogenous antimicrobial peptides. This study sought to assess if low serum concentrations of 25(OH)D were associated with higher sepsis mortality rates.
Methods: This is a prospective study composed of participants from the WomenÕs health Initiative (WHI) in the Vitamin D/Calcium trial who have been followed for an average of 15 years. The analysis sample consists of participants who had 25(OH)D measured at baseline. Patients with kidney disease and self-reported cancer at enrollment were excluded. Vitamin D deficiency was defined as levels ² 20 ng/mL, which was categorized into severe deficiency [25(OH)D ²12 ng/ml] and mild deficiency [25(OH) of 12-20 ng/ml]. Cox proportional hazard model was used to study the association between serum Vitamin D and sepsis mortality.
Results: 10, 814 participants were included in the study (Mean age= 64.4 years). At baseline, 49.26 % (n=5328) of the sample had vitamin D deficiency and of those who died from sepsis, 57.7 % (n=41) where found to be vitamin D deficient. We found statistically significant increased hazard ratios (HR) for sepsis mortality in mild (HR= 1.19; 95% CI 1.00-1.41) and severe vitamin D deficiency (HR= 1.82; 95% CI: 1.50-2.21) in age adjusted and fully adjusted models.(Table 1).
Conclusion: Vitamin D deficiency is associated with increased risk of sepsis mortality in postmenopausal women, which was seen in all ages. A clinical trial evaluating adequate supplementation in patients with sepsis is recommended to assess clinical significance.
W. Salazar, None
M. Roberts, None
C. Eaton, None
L. Snetselaar, None
M. LeBoff, None
J. Manson, None
I. Kato, None
E. S. LeBlanc, None