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Race and 25-Hydroxyvitamin D Deficiency in the Critically Ill: Does It Matter? FREE TO VIEW

Liam Gross, DO; Mihaela Oprea, MD; Mastian Chand, MD; Cristina Gutierrez, MD
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New York Hospital of Queens, Flushing, NY

Chest. 2013;144(4_MeetingAbstracts):558A. doi:10.1378/chest.1703544
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SESSION TITLE: Outcomes/Quality Control Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: 25-hydroxyvitamin D(VitD) deficiency has been associated with poor outcomes in the ICU. In patients with chronic conditions, VitD levels and race are associated with increased morbidity. Given the large racial diversity in our population, we evaluated the correlation of these two variables with poor outcomes in the critically ill.

METHODS: All patients with measured serum VitD levels within 24hrs of admission to the ICU were included. Demographic data included age, gender, race, and place of living prior to admission. Clinical data included comorbidities, diagnosis on admission, positive blood cultures, use of mechanical ventilation(MV), and vasopressors. Primary and secondary outcomes measured included mortality, days on MV, and length of stay(LOS) in ICU. T-test and chi-square were used to analyze data.

RESULTS: A total of 94 patients were included in the study; 66% of the patients had VitD deficiency(<20ng/ml) with mean levels of 12.6±5.2ng/ml. There were no statistical differences in age, gender, comorbidities, place of living, or diagnosis on admission between patients with and without VitD deficiency. Blood cultures were obtained in 79.8% of patients, with no difference in positive cultures between the two groups. Patients with VitD deficiency were more likely to have been on vasopressors(15.6%vs38.7%; p=0.02), however, there was no difference in use of MV, days on MV, rate of successful extubation, or need for tracheostomy. ICU LOS and mortality were similar in both patients with and without VitD deficiency. 50% of our population consisted of Asians, African-Americans and Hispanics. The incidence of VitD deficiency did not differ significantly among races(p=0.31), and had no impact on days on MV, ICU LOS, or mortality(p>0.05).

CONCLUSIONS: While race has proven to be an important factor in poor outcomes in patients with VitD deficiency and chronic conditions, this effect is not reproduced in the acutely critically ill.

CLINICAL IMPLICATIONS: Race is not a factor in poor outcomes in ICU patients with VitD deficiency

DISCLOSURE: The following authors have nothing to disclose: Liam Gross, Mihaela Oprea, Mastian Chand, Cristina Gutierrez

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