- \(\bf Background\)
Vitamin D has immunomodulatory properties and seems to reduce the risk of infections. Whether low vitamin D concentrations are independent risk factors for nosocomial postoperative infections in surgical patients remains to be studied in detail.
\(\bf Methods\)
In 3,340 consecutive cardiac surgical patients, we investigated the association of circulating 25-hydroxyvitamin D (25OHD; indicator of nutritional vitamin D status) and 1,25-dihydroxy-vitamin D (\(1,25[OH]_{2}D\); active vitamin D hormone) with nosocomicial infections. The primary endpoint was a composite of thoracic wound infection, sepsis, and broncho-pulmonary infection. Vitamin D status was measured on the last preoperative day. Infections were assessed until discharge. Logistic regression analysis was used to examine the association between vitamin D metabolite concentrations and the composite endpoint.
\(\bf Results\)
The primary endpoint was reached by 5.6% (n = 186). In patients who reached and did not reach the endpoint, in-hospital mortality was 13.4% and 1.5%, respectively (P<0.001). Median (IQR) 25OHD and \(1,25(OH)_{2}D\) concentrations were 43. 2 (29.7–61.9) nmol/l and 58.0 (38.5–77.5) pmol/l, respectively. Compared with the highest \(1,25(OH)_{2}D\) quintile (>81.0 pmol/l), the multivariable–adjusted odds ratio of infection was 2.57 (95%CI:1.47–4.49) for the lowest \(1,25(OH)_{2}D\) quintile (<31.5 pmol/l) and 1.85 (95%CI:1.05–3.25) for the second lowest quintile (31.5–49.0 pmol/l). There was no significant association between 25OHD concentrations and the primary endpoint.
\(\bf Conclusions\)
Our data indicate an independent association of low \(1,25(OH)_{2}D\) levels with the risk of post-operative infections in cardiac surgical patients. Future studies should pay more attention on the clinical relevance of circulating \(1,25(OH)_{2}D\) and its regulation.
MetadatenAuthor: | Armin ZittermannORCiDGND, Joachim KuhnGND, Jana Barbara ErnstGND, Tobias BeckerGND, Julia LarischGND, Jens DreierGND, Cornelius KnabbeGND, Jochen BörgermannGND, Jan GummertORCiDGND |
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URN: | urn:nbn:de:hbz:294-58467 |
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DOI: | https://doi.org/10.1371/journal.pone.0158532 |
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Parent Title (English): | PLoS one |
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Subtitle (English): | the CALCITOP-study |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2018/07/05 |
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Date of first Publication: | 2016/06/29 |
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Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
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Tag: | Open Access Fonds |
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Volume: | 11 |
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Issue: | 6 |
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First Page: | e0158532-1 |
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Last Page: | e0158532-11 |
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Note: | Article Processing Charge funded by the Open Access Publication Fund of Ruhr-Universität Bochum. |
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Note: | PLoS ONE, Bd. 11, H. 6, Artikelnummer e0158532 |
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Institutes/Facilities: | Herz- und Diabeteszentrum NRW, Klinik für Thorax- und Kardiovaskularchirurgie |
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Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
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open_access (DINI-Set): | open_access |
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faculties: | Medizinische Fakultät |
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Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |
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