Vitamin D deficiency at pediatric intensive care admission

Rey, Corsino; Sánchez-Arango, David; López-Herce, Jesús; Martínez-Camblor, Pablo; García-Hernández, Irene; Prieto, Belén; Pallavicini, Zamir

doi:10.1016/j.jpedp.2013.08.010

Informação do artigo

Abstract

Objective

to assess whether 25hydroxivitaminD or 25(OH)vitD deficiency has a high prevalence at pediatric intensive care unit (PICU) admission, and whether it is associated with increased prediction of mortality risk scores.

Method

prospective observational study comparing 25(OH)vitD levels measured in 156 patients during the 12hours after critical care admission with the 25(OH)vitD levels of 289 healthy children. 25(OH)vitD levels were also compared between PICU patients with pediatric risk of mortality III (PRISM III) or pediatric index of mortality 2 (PIM 2) > p75 [(group A; n = 33) vs. the others (group B; n = 123)]. Vitamin D deficiency was defined as < 20 ng/mL levels.

Results

median (p25-p75) 25(OH)vitD level was 26.0 ng/mL (19.2-35.8) in PICU patients vs. 30.5 ng/mL (23.2-38.6) in healthy children (p = 0.007). The prevalence of 25(OH) vitD < 20 ng/mL was 29.5% (95% CI: 22.0-37.0) vs. 15.6% (95% CI: 12.2-20.0) (p = 0.01).

Pediatric intensive care patients presented an odds ratio (OR) for hypovitaminosis D of 2.26 (CI 95%: 1.41-3.61). 25(OH)vitD levels were 25.4 ng/mL (CI 95%: 15.5-36.0) in group

A vs. 26.6 ng/mL (CI 95%: 19.3-35.5) in group B (p = 0.800).

Conclusions

hypovitaminosis D incidence was high in PICU patients. Hypovitaminosis D was not associated with higher prediction of risk mortality scores.

Keywords:

25 hydroxivitamin D

Critically-ill children

Critical care

Prognostic markers

Mortality risk

Resumo

Objetivo

avaliar se a deficiência da 25-hidroxivitamina D, ou 25 (OH) vitD, tem preva- lência elevada em internações na unidade de terapia intensiva pediátrica, e se estaria relacionada à previsão de escores de risco de mortalidade.

Método

estudo observacional prospectivo comparando níveis de 25 (OH) vitD de 156 pacientes, mensurados nas primeiras 12 horas da internação em terapia intensiva, com níveis de 25 (OH) vitD de 289 crianças saudáveis. Os níveis de 25 (OH) vitD também foram comparados entre pacientes na UTIP com escore PRISM III ou PIM 2 > p75 (Grupo A; n = 33), e o restante, (Grupo B; n = 123). A deficiência de vitamina D foi definida como níveis < 20 ng/mL.

Resultados

o nível médio (p25-p75) de 25 (OH) vitD foi 26,0 ng/mL (19,2-35,8) em pacientes internados na UTIP, em comparação a 30,5 ng/mL (23,2-38,6) em crianças sau- dáveis (p = 0,007). A prevalência de 25 (OH) vitD < 20 ng/mL foi de 29,5% (IC 95%, 22,0- 37,0), em comparação a 15,6% (IC 95%,12,2-20,0) (p = 0,01). Os pacientes em terapia intensiva pediátrica apresentaram uma razão de chance (RC) para hipovitaminose D de 2,26 (IC 95%, 1,41-3,61). Os níveis de 25 (OH) vitD foram 25,4 ng/mL (IC 95%, 15,5-36,0) no grupo A, em comparação a 26,6 ng/mL (IC 95%, 19,3-35,5) no grupo B (p = 0,800).

Conclusões

a incidência de hipovitaminose D foi elevada em pacientes em terapia inten- siva pediátrica, mas não foi associada à maior previsão de escores de risco de mortali- dade.

Palavras-chave:

25-hidroxivitamina D

Crianças gravemente doentes

Terapia intensiva

Indicadores prognósticos

Risco de mortalidade

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Como citar este artigo: Rey C, Sánchez-Arango D, López-Herce J, Martínez-Camblor P, García-Hernández I, Prieto B, et al. Vitamin D deficiency at pediatric intensive care admission. J Pediatr (Rio J). 2014;90:135-42.

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