Prevalence of vitamin deficiencies on admission : relationship to hospital mortality in critically ill patients

• Published in: Anaesthesia and intensive care 2009-03, Vol.37 (2), p.254-260
• Main Authors: CORCORAN, T. B, O'NEILL, M. A, WEBB, S. A. R, HO, K. M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; APACHE; Australia; Avitaminosis - epidemiology; Biological and medical sciences; C-Reactive Protein - analysis; Care and treatment; Cohort Studies; Complications and side effects; Critical Illness - mortality; Critically ill; Female; Hospital Mortality; Humans; Male; Medical sciences; Middle Aged; Mortality; Physiological aspects; Prevalence; Prospective Studies; Risk factors; Vitamin deficiency
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x0903700215

Vitamin deficiency is believed to be common in critical illness. Water soluble and antioxidant vitamins are those most frequently used for supplementation in these patients. There are no data to confirm the prevalence of vitamin deficiencies in high-risk emergently admitted intensive care patients, nor their association with hospital mortality. One hundred and twenty-nine consecutive, critically ill patients who were emergently admitted to intensive care were enrolled in this prospective observational cohort study. Patient data including diagnosis, source of admission and severity of illness scores were prospectively collected. Within the first 48 hours of admission, concentrations of C-reactive protein, Vitamins A, E, B1, B12 and folate were measured on arterial blood. Multivariate stepwise logistic regression modelling was performed to examine the association of vitamin concentrations with hospital mortality. Fifty-five patients (43%) had a biochemical deficiency of one of the five vitamins on admission to the intensive care unit. A total of 18 patients died (14%) during their hospital stay (15 of those in the intensive care unit). Moderate correlations with C-reactive protein concentrations were demonstrated for Vitamins B12, A and E (Spearman's r = 0.309, -0.541 and -0.299, P = 0.001, 0.001 and 0.007 respectively). Hospital mortality was significantly associated with age, APACHE II score, admission and maximum Sequential Organ Failure Assessment scores and admission source in the univariate analyses. Multivariate analysis did not demonstrate an association between biochemical deficiency and mortality. Biochemical deficiencies of water-soluble and antioxidant vitamins are common on admission in unplanned or emergency admissions to the intensive care unit, but we could not demonstrate an independent association with hospital mortality.