Vitamin D and outcomes in adult critically ill patients. A systematic review and meta-analysis of randomized trials

Abstract Purpose Low Vitamin D blood levels are associated with high mortality in critically ill patients. There is controversy about Vitamin D supplementation in this population. The objective of this meta-analysis was to evaluate if Vitamin D administration reduces mortality in critically ill pati...

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Bibliographic Details
Published in:Journal of critical care 2017-04, Vol.38, p.109-114
Main Authors: Putzu, Alessandro, Belletti, Alessandro, Cassina, Tiziano, Clivio, Sara, Monti, Giacomo, Zangrillo, Alberto, Landoni, Giovanni
Format: Article
Language:English
Subjects:
Bias
Critical Care
Critical illness
Critical Illness - mortality
Dietary Supplements
Hospitals
Humans
Hypotheses
Hypothesis testing
Intensive Care Units
Intervention
Meta-analysis
Mortality
Population
Randomized Controlled Trials as Topic
Sepsis
Studies
Survival
Vitamin D
Vitamin D - administration & dosage
Vitamin D - blood
Vitamin deficiency
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Summary:Abstract Purpose Low Vitamin D blood levels are associated with high mortality in critically ill patients. There is controversy about Vitamin D supplementation in this population. The objective of this meta-analysis was to evaluate if Vitamin D administration reduces mortality in critically ill patients. Materials and Methods Online databases were searched up to September 1st 2016 for randomized placebo-controlled trials on the use of Vitamin D in adult patients with critical illness. The primary endpoint was mortality among trials with low risk of bias. The secondary endpoints were: length of hospital stay, length of intensive care unit stay, length of mechanical ventilation, and adverse events. Results Seven studies published between 2011 and 2016, for a total of 716 patients, were included in the analysis. Vitamin D administration was associated with significantly lower mortality compared to placebo (101/320 [32%] in the Vitamin D group versus 123/307 [40%] in the placebo group, OR =0.70 [95% CI, 0.50, 0.98], P = .04, I2 = 0%). No differences in adverse events and other secondary endpoints were found. Conclusions In critically ill patients, Vitamin D administration might be associated with a reduction in mortality without significant adverse events. A large multicenter randomized trial should conclusively confirm these findings.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2016.10.029