Vitamin D supplementation is beneficial in improving the prognosis of patients with acute respiratory failure in the intensive care unit: a retrospective study based on the MIMIC-IV database

DOI record: { "DOI": "10.3389/fmed.2023.1271060", "ISSN": [ "2296-858X" ], "URL": "http://dx.doi.org/10.3389/fmed.2023.1271060", "abstract": "<jats:sec><jats:title>Background</jats:title><jats:p>Vitamin D plays a critical role in the regulation of multiple physiological pathways. Vitamin D deficiency may be a risk factor for life-threatening clinical conditions. Several studies have found that vitamin D supplementation in critically ill patients improves prognosis. The purpose of this study was to determine the association between vitamin D and the prognosis of patients with acute respiratory failure (ARF).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In this retrospective cohort study, we collected clinical information of ARF patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) version 2.0 database. The outcome of this study was in-hospital mortality, intensive care unit (ICU) mortality. Patients were divided into the no-vitamin D and vitamin D groups according to whether they received supplementation or not. The correlation between vitamin D and outcome was examined using Kaplan–Meier (KM) survival curves, Cox proportional risk regression models and subgroup analyses. Propensity-score matching (PSM) was used to ensure the robustness of our findings.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The study finally included 7,994 patients with ARF, comprising 6,926 and 1,068 in the no-vitamin D and vitamin D groups, respectively. The Kaplan–Meier survival curve indicated a significant difference in survival probability between the two groups. After adjustment for a series of confounders, the multivariate Cox proportional hazards models showed that the hazard ratio (95% confidence interval) values for in-hospital and ICU mortality in the no-vitamin D group were 1.67 (1.45, 1.93) and 1.64 (1.36, 1.98), respectively. The results of propensity score-matched (PSM) analysis were consistent with the original population. In the subgroup analysis, Vitamin D supplementation was associated with lower in-hospital mortality in patients with higher clinical scores (SOFA score ≥ 8, OASIS ≥ 38).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our study concluded that Vitamin D supplementation may reduce in-hospital and ICU mortality in patients with ARF in the ICU. There may be a beneficial effect on in-hospital mortality in patients with higher clinical scores. Additional randomized controlled trials are needed to follow up to confirm the relationship between vitamin D supplementation and ARF.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fmed.2023.1271060" ], "author": [ { "affiliation": [], "family": "Hu", "given": "Song", "sequence": "first" }, { "affiliation": [], "family": "He", "given": "Qian", "sequence": "additional" }, { "affiliation": [], "family": "Xie", "given": "Jun", "sequence": "additional" }, { "affiliation": [], "family": "Liu", "given": "Hui", "sequence": "additional" }, { "affiliation": [], "family": "Zhou", "given": "Rong", "sequence": "additional" }, { "affiliation": [], "family": "Li", "given": "Chong", "sequence": "additional" } ], "container-title": "Frontiers in Medicine", "container-title-short": "Front. 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Lancet", "author": "JP", "doi-asserted-by": "publisher", "first-page": "646", "journal-title": "Respir Med", "key": "ref2", "volume": "4", "year": "2016" }, { "DOI": "10.1016/S2213-2600(18)30345-X", "article-title": "Acute respiratory failure in immunocompromised adults", "author": "Azoulay", "doi-asserted-by": "publisher", "first-page": "173", "journal-title": "Lancet Respir Med", "key": "ref3", "volume": "7", "year": "2019" }, { "DOI": "10.1016/J.Pedneo.2019.04.007", "article-title": "Vitamin D and health - the missing Vitamin in humans", "author": "SW", "doi-asserted-by": "publisher", "first-page": "237", "journal-title": "Pediatr Neonatol", "key": "ref4", "volume": "60", "year": "2019" }, { "DOI": "10.1016/J.Jsbmb.2018.09.003", "article-title": "The serum vitamin D metabolome: what we know and what is still to discover", "author": "Tuckey", "doi-asserted-by": "publisher", "first-page": "4", "journal-title": "J Steroid Biochem", "key": "ref5", "volume": "186", "year": "2019" }, { "DOI": "10.1016/J.Ecl.2017.07.001", "article-title": "Biology and mechanisms of action of the Vitamin D hormone", "author": "Pike", "doi-asserted-by": "publisher", "first-page": "815", "journal-title": "Clin Endocrinol Metab", "key": "ref6", "volume": "46", "year": "2017" }, { "DOI": "10.1007/S00418-018-1648-Y", "article-title": "Functions of Vitamin D in bone", "author": "Goltzman", "doi-asserted-by": "publisher", "first-page": "305", "journal-title": "Histochem Cell Biol", "key": "ref7", "volume": "149", "year": "2018" }, { "DOI": "10.1038/Ki.2008.501", "article-title": "Vitamin D levels and patient outcome in chronic kidney disease", "author": "Ravani", "doi-asserted-by": "publisher", "first-page": "88", "journal-title": "Kidney Int", "key": "ref8", "volume": "75", "year": "2009" }, { "DOI": "10.3390/Ijms21186483", "article-title": "Vitamin D and cardiovascular disease, with emphasis on hypertension, atherosclerosis, and heart failure", "author": "Latic", "doi-asserted-by": "publisher", "first-page": "21", "journal-title": "Int J Mol Sci", "key": "ref9", "volume": "21", "year": "2020" }, { "DOI": "10.3390/Nu12072097", "article-title": "Immunologic effects of vitamin D on human health and disease", "author": "Charoenngam", "doi-asserted-by": "publisher", "first-page": "2097", "journal-title": "Nutrients", "key": "ref10", "volume": "12", "year": "2020" }, { "DOI": "10.1038/S41430-020-0558-Y", "article-title": "Vitamin D deficiency 2.0: an update on the current status worldwide", "author": "Amrein", "doi-asserted-by": "publisher", "first-page": "1498", "journal-title": "Eur J Clin Nutr", "key": "ref11", "volume": "74", "year": "2020" }, { "DOI": "10.7326/M22-3018", "article-title": "Vitamin D and risk for type 2 diabetes in people with prediabetes: a systematic review and meta-analysis of individual participant data from 3 randomized clinical trials", "author": "Ag", "doi-asserted-by": "publisher", "first-page": "355", "journal-title": "Ann Intern Med", "key": "ref12", "volume": "176", "year": "2023" }, { "DOI": "10.3390/Brainsci11030334", "article-title": "The role of vitamin D as a biomarker in Alzheimer’s disease", "author": "Bivona", "doi-asserted-by": "publisher", "first-page": "334", "journal-title": "Brain Sci", "key": "ref13", "volume": "11", "year": "2021" }, { "DOI": "10.3390/Nu12040988", "article-title": "Evidence that Vitamin D supplementation could reduce risk of influenza and Covid-19 infections and deaths", "author": "Grant", "doi-asserted-by": "publisher", "journal-title": "Nutrients", "key": "ref14", "volume": "12", "year": "2020" }, { "DOI": "10.3390/Nu15061486", "article-title": "Serum 25-Hydroxy Vitamin D levels in children with acute respiratory infections caused by respiratory virus or atypical pathogen infection", "author": "Kuang", "doi-asserted-by": "publisher", "first-page": "1486", "journal-title": "Nutrients", "key": "ref15", "volume": "15", "year": "2023" }, { "DOI": "10.1136/Bmj.I6583", "article-title": "Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and Meta-analysis of individual participant data", "author": "AR", "doi-asserted-by": "publisher", "first-page": "I6583", "journal-title": "BMJ", "key": "ref16", "volume": "356", "year": "2017" }, { "DOI": "10.1016/S0140-6736(20)30183-5", "article-title": "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China", "author": "Huang", "doi-asserted-by": "publisher", "first-page": "497", "journal-title": "Lancet", "key": "ref17", "volume": "395", "year": "2020" }, { "DOI": "10.13026/7vcr-E114", "article-title": "Mimic-iv (version 2.0)", "author": "Johnson", "doi-asserted-by": "publisher", "journal-title": "Physionet", "key": "ref18", "year": "2022" }, { "DOI": "10.1136/Postgradmedj-2020-138234", "article-title": "Origin, transmission, diagnosis and management of coronavirus disease 2019 (covid-19)", "author": "Umakanthan", "doi-asserted-by": "publisher", "first-page": "753", "journal-title": "Postgrad Med J", "key": "ref19", "volume": "96", "year": "2020" }, { "DOI": "10.1007/S11154-021-09679-5", "article-title": "Infections and immunity", "author": "Ismailova", "doi-asserted-by": "publisher", "first-page": "265", "journal-title": "Rev Endocr Metab Disord", "key": "ref20", "volume": "23", "year": "2022" }, { "DOI": "10.1038/S41598-022-24053-4", "article-title": "Association between vitamin D supplementation and COVID-19 infection and mortality", "author": "JB", "doi-asserted-by": "publisher", "first-page": "19397", "journal-title": "Sci Rep", "key": "ref21", "volume": "12", "year": "2022" }, { "DOI": "10.1007/S40618-021-01639-9", "article-title": "Vitamin D supplementation and Covid-19 risk: a population-based, cohort study", "author": "Oristrell", "doi-asserted-by": "publisher", "first-page": "167", "journal-title": "J Endocrinol Investig", "key": "ref22", "volume": "45", "year": "2022" }, { "DOI": "10.1016/J.Jsbmb.2019.105552", "article-title": "A mouse model for vitamin D-induced human cathelicidin antimicrobial peptide gene expression", "author": "MB", "doi-asserted-by": "publisher", "first-page": "105552", "journal-title": "Mol Biol", "key": "ref23", "volume": "198", "year": "2020" }, { "DOI": "10.1093/Femspd/Ftac014", "article-title": "Vitamin D-induced Ll-37 modulates innate immune responses of human primary macrophages during Denv-2 infection", "author": "JA", "doi-asserted-by": "publisher", "first-page": "ftac014", "journal-title": "Pathog Dis", "key": "ref24", "volume": "80", "year": "2022" }, { "DOI": "10.3390/Ph14020172", "article-title": "Up-regulated vitamin D receptor by pelargonium sidoides extract eps® 7630 contributes to rhinovirus defense in bronchial epithelial cells", "author": "Roth", "doi-asserted-by": "publisher", "first-page": "172", "journal-title": "Pharmaceuticals (Basel)", "key": "ref25", "volume": "14", "year": "2021" }, { "DOI": "10.1111/Apm.12982", "article-title": "Effect of single‐dose injection of vitamin D on immune cytokines in ulcerative colitis patients: a randomized placebo‐controlled trial", "author": "Sharifi", "doi-asserted-by": "publisher", "first-page": "681", "journal-title": "Acta Pathol Microbiol Immunol Scand Section C Immunol", "key": "ref26", "volume": "127", "year": "2019" }, { "DOI": "10.1002/Hep.30887", "article-title": "Vitamin D receptor activation in liver macrophages protects against hepatic endoplasmic reticulum stress in mice", "author": "Zhou", "doi-asserted-by": "publisher", "first-page": "1453", "journal-title": "Hepatology", "key": "ref27", "volume": "71", "year": "2020" }, { "DOI": "10.1186/S13052-019-0634-X", "article-title": "Vitamin D inhibits pro-inflammatory cytokines in the airways of cystic fibrosis patients infected by Pseudomonas Aeruginosa- pilot study", "author": "Olszowiec-Chlebna", "doi-asserted-by": "publisher", "first-page": "41", "journal-title": "Ital J Pediatr", "key": "ref28", "volume": "45", "year": "2019" }, { "DOI": "10.1001/Archinte.167.16.1730", "article-title": "Vitamin D supplementation and Total mortality: a Meta-analysis of randomized controlled trials", "author": "Autier", "doi-asserted-by": "publisher", "first-page": "1730", "journal-title": "Arch Intern Med", "key": "ref29", "volume": "167", "year": "2007" }, { "DOI": "10.1177/2050640618811489", "article-title": "Vitamin D deficiency predicts severe acute pancreatitis", "author": "Huh", "doi-asserted-by": "publisher", "first-page": "90", "journal-title": "UEG J", "key": "ref30", "volume": "7", "year": "2019" }, { "DOI": "10.1136/Bmj.L4673", "article-title": "Association between Vitamin D supplementation and mortality: systematic review and Meta-analysis", "author": "Zhang", "doi-asserted-by": "publisher", "first-page": "L4673", "journal-title": "BMJ", "key": "ref31", "volume": "366", "year": "2019" }, { "DOI": "10.1371/Journal.Pmed.1003999", "article-title": "Covit-trial study group. High-dose versus standard-dose Vitamin D supplementation in older adults with Covid-19 (Covit-trial): a multicenter, open-label, randomized controlled superiority trial", "author": "Annweiler", "doi-asserted-by": "publisher", "first-page": "E1003999", "journal-title": "PLoS Med", "key": "ref32", "volume": "19", "year": "2022" }, { "DOI": "10.3390/Nu15051234", "article-title": "Vitamin D supplementation and clinical outcomes in severe Covid-19 patients-randomized controlled trial", "author": "Domazet Bugarin", "doi-asserted-by": "publisher", "first-page": "1234", "journal-title": "Nutrients", "key": "ref33", "volume": "15", "year": "2023" }, { "DOI": "10.1007/S40618-020-01370-X", "article-title": "Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to Covid-19", "author": "GE", "doi-asserted-by": "publisher", "first-page": "765", "journal-title": "J Endocrinol Investig", "key": "ref34", "volume": "44", "year": "2021" }, { "DOI": "10.1001/Jama.286.14.1754", "article-title": "Serial evaluation of the SOFA score to predict outcome in critically ill patients", "author": "Ferreira", "doi-asserted-by": "publisher", "first-page": "1754", "journal-title": "JAMA", "key": "ref35", "volume": "286", "year": "2001" }, { "DOI": "10.7717/Peerj.7083", "article-title": "Prognosis predictive value of the Oxford acute severity of illness score for Sepsis: a retrospective cohort study", "author": "Chen", "doi-asserted-by": "publisher", "first-page": "E7083", "journal-title": "Peerj", "key": "ref36", "volume": "7", "year": "2019" }, { "DOI": "10.1186/S12931-021-01666-3", "article-title": "Circulating Vitamin D levels status and clinical prognostic indices in Covid-19 patients", "author": "Ricci", "doi-asserted-by": "publisher", "first-page": "76", "journal-title": "Respir Res", "key": "ref37", "volume": "22", "year": "2021" } ], "reference-count": 37, "references-count": 37, "relation": {}, "resource": { "primary": { "URL": "https://www.frontiersin.org/articles/10.3389/fmed.2023.1271060/full" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [ "General Medicine" ], "subtitle": [], "title": "Vitamin D supplementation is beneficial in improving the prognosis of patients with acute respiratory failure in the intensive care unit: a retrospective study based on the MIMIC-IV database", "type": "journal-article", "update-policy": "http://dx.doi.org/10.3389/crossmark-policy", "volume": "10" }