The relationship between immediate preoperative serum 25-hydroxy-vitamin D3 levels and cardiac function, dysglycemia, length of stay, and 30-d readmissions in cardiac surgery patients

• DOI: 10.1016/j.nut.2014.11.022
• Publication Date: 2014-12-30T17:41:00Z
• Authors: Krishnan Sriram; Kalyani Perumal; Golnaz Alemzadeh; Albert Osei; Gennadiy Voronov
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 8. Economic growth; 3. Good health

Abstract Objectives Vitamin D has pleiotropic effects on cardiac, renal, and endocrine diseases like diabetes mellitus and deficiency has been correlated with increased Intensive Care Unit (ICU) morbidity and mortality. We studied the relationship between preoperative Vitamin D levels and several short-term endpoints including cardiovascular events, glucose levels, ICU, and hospital length of stay. Methods Standard demographic data were obtained. Blood samples were drawn for 25-hydroxy-vitamin D 3 (Vit D) levels at baseline (just before induction of anesthesia) and on postoperative day (POD #1). The number of inotropes used on POD # 0, 1, and 2 was recorded as well as the Cardiac Index (CI). Baseline glucose, Blood Urea Nitrogen and Creatinine (Cr) levels were obtained and repeated on POD # 1 & 2. Other variables studied are number of days of ICU and hospital stay. Results Of the 64 patients included in the cohort, 3 were excluded because of inadequate data. 69% had Vit D levels P Conclusions The low levels in this study truly represent the Vit D status as they were obtained before any intervention, including surgery or fluid administration. Vit D levels decreased rapidly after surgery and hence future studies on Vit D may need to focus on premorbid levels obtained at the time of initial presentation and not those obtained after resuscitation or ICU admission. In contrast to epidemiologic reports, we found no association between low Vit D levels and postoperative cardiovascular events. However, low Vit D levels did affect the ICU and hospital length of stay in patients who were undergoing cardiac surgery. This is an important finding especially when many institutions and regulatory agencies are investigating novel therapies and processes to reduce the length of hospitalization. More studies are required to investigate the effect on hospital length of stay of early preadmission or preoperative Vit D supplementation before elective surgery.