Vitamin D and delirium in critically ill patients: a preliminary investigation.

Morandi A, Barnett N, Miller RR, Girard TD, Pandharipande PP, Ely EW, Ware LB
J Crit Care. 2013 28 (3): 230-5

PMID: 22884531 · PMCID: PMC3498519 · DOI:10.1016/j.jcrc.2012.06.011

PURPOSE - The pathophysiology of delirium in critical illness is unclear. 25-OH vitamin D (25-OHD) has neuroprotective properties but a relationship between serum 25-OHD and delirium has not been examined. We tested the hypothesis that low serum 25-OHD is associated with delirium during critical illness.

MATERIALS AND METHODS - In a prospective cohort of 120 medical intensive care unit (ICU) patients, blood was collected within 24 hours of ICU admission for measurement of 25-OHD. Delirium was identified once daily using the Confusion Assessment Method for the ICU. Multivariable logistic regression was used to analyze the association between 25-OHD and delirium assessed the same day and the subsequent day after 25-OHD measurement, with adjustments for age and severity of illness.

RESULTS - Median age was 52 years (interquartile range, 40-62), and Acute Physiology and Chronic Health Evaluation II was 23 (interquartile range, 17-30). Thirty-seven patients (41%) were delirious on the day of 25-OHD measurement. 25-OHD levels were not associated with delirium on the day of 25-OHD measurement (odds ratio, 1.01; 95% confidence interval, 0.98-1.02) or on the day after measurement (odds ratio, 1.01; 95% confidence interval, 0.99-1.03).

CONCLUSIONS - This pilot study suggests that 25-OHD levels measured early during critical illness are not important determinants of delirium risk. Since 25-OHD levels can fluctuate during critical illness, a study of daily serial measurements of 25-OHD levels and their relationship to delirium during the duration of critical illness may yield different results.

Copyright © 2013 Elsevier Inc. All rights reserved.

MeSH Terms (16)

Acute Lung Injury Adult Age Factors Critical Illness Delirium Female Humans Intensive Care Units Logistic Models Male Middle Aged Pilot Projects Prospective Studies Risk Factors Severity of Illness Index Vitamin D Deficiency

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