caa a22 4500 605463646 CHVBK 20210128100254.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00774-014-0585-7 doi (NATIONALLICENCE)springer-10.1007/s00774-014-0585-7 Supraphysiological 25-hydroxy vitamin D3 level at admission is associated with illness severity and mortality in critically ill patients [Elektronische Daten] [Ravikar Ralph, John Peter, Anugrah Chrispal, Anand Zachariah, Joseph Dian, Tunny Sebastian, Bala Venkatesh, Kurien Thomas] We studied the association between admission serum 25-hydroxy vitamin D3 level and in-hospital mortality in a prospective cohort of critically ill patients admitted to the medical intensive care unit of a tertiary care referral center. Of the 180 patients enrolled, 129 were included. Vitamin D3 deficiency was observed in 37% (n=48) and supra-physiological levels (≥250nmol/L) in 15.5% (n=20). Patients with supraphysiological vitamin D3 levels were grouped as outliers. There was no difference in mortality (p=0.41) between vitamin D3 deficient (21/48) and non-deficient (36/81) patients in analysis with and without outliers. Patients with vitamin D3 ≥250nmol/L had a significantly higher (p=0.02) Simplified Acute Physiology Score (SAPS) II and mortality (p=0.003) [mean (SD) 60.1±17.1 and 75% (15/20), respectively] when compared with the rest [45.6±18 and 38.5% (42/109), respectively]. The sensitivity, specificity and SAPS II independent odds ratio to predict mortality in patients with supraphysiological vitamin D3 levels were 26.3, 93.1 and 3.7% (95% confidence interval 1.2-11.4; p=0.03), respectively. In conclusion, vitamin D3 deficiency in our cohort was not associated with mortality. A patient subset with supra-physiological vitamin D levels had higher illness severity scores and mortality. Extrinsic factors interfering with test results were ruled out. A biological hypothesis to explain this observation is proposed. Further clarification of mechanisms leading to this observation is warranted. The Japanese Society for Bone and Mineral Research and Springer Japan, 2014 25-Hydroxyvitamin D nationallicence Critical illness nationallicence SAPS II score nationallicence Mortality nationallicence Ralph Ravikar Department of Medicine, Christian Medical College Hospital (CMCH), Vellore, India aut Peter John Medical Intensive Care Unit, CMCH, Vellore, India aut Chrispal Anugrah Department of Medicine, Christian Medical College Hospital (CMCH), Vellore, India aut Zachariah Anand Department of Medicine, Christian Medical College Hospital (CMCH), Vellore, India aut Dian Joseph Department of Clinical Biochemistry, CMCH, Vellore, India aut Sebastian Tunny Department of Biostatistics, CMCH, Vellore, India aut Venkatesh Bala Department of Intensive Care, The University of Queensland, St Lucia, Australia aut Thomas Kurien Department of Medicine, Christian Medical College Hospital (CMCH), Vellore, India aut Journal of Bone and Mineral Metabolism Springer Japan 33/2(2015-03-01), 239-243 0914-8779 33:2<239 2015 33 774 https://doi.org/10.1007/s00774-014-0585-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 brief-communication jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00774-014-0585-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ralph Ravikar Department of Medicine, Christian Medical College Hospital (CMCH), Vellore, India aut NATIONALLICENCE 700 1- Peter John Medical Intensive Care Unit, CMCH, Vellore, India aut NATIONALLICENCE 700 1- Chrispal Anugrah Department of Medicine, Christian Medical College Hospital (CMCH), Vellore, India aut NATIONALLICENCE 700 1- Zachariah Anand Department of Medicine, Christian Medical College Hospital (CMCH), Vellore, India aut NATIONALLICENCE 700 1- Dian Joseph Department of Clinical Biochemistry, CMCH, Vellore, India aut NATIONALLICENCE 700 1- Sebastian Tunny Department of Biostatistics, CMCH, Vellore, India aut NATIONALLICENCE 700 1- Venkatesh Bala Department of Intensive Care, The University of Queensland, St Lucia, Australia aut NATIONALLICENCE 700 1- Thomas Kurien Department of Medicine, Christian Medical College Hospital (CMCH), Vellore, India aut NATIONALLICENCE 773 0- Journal of Bone and Mineral Metabolism Springer Japan 33/2(2015-03-01), 239-243 0914-8779 33:2<239 2015 33 774