Document Type : Original Article


1 Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Clinical Pharmacy, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Intensive Care Unit, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran


Objective: There is few data regarding the correlation between serum Vitamin D level 
and unfavorable intensive care unit (ICU) outcome in postsurgical patients. In this study, 
correlation between serum 25(OH)D level and length of ICU stay and in‑hospital mortality 
has been evaluated in critically ill surgical patients.
Methods: Serum 25(OH)D has been evaluated in 70 surgical, critically ill patients. 
Demographic, laboratory, and clinical data of the patients were collected. Correlation between 
serum 25(OH) D level and duration of ICU stay and hospital mortality was evaluated using 
two‑factor analysis of covariance. Multivariable Cox‑regression analysis was used for adjusting 
the effect of season of blood sampling and type of surgery on the main variables. For all 
the analyses, P values less than or equal to 0.05 were considered as statistically significant.
Findings: Serum 25(OH)D deficiency was identified in 52 (74.3%) of the patients. Patients 
with serum Vitamin D levels < 30 ng/ml had longer length of ICU stay than those with 
serum Vitamin D levels ≥ 30 ng/ml (7.8 ± 5.1 vs. 4.05 ± 2.12 days, P = 0.003). Although 
hospital mortality was more common in Vitamin D deficient patients than sufficient ones 
(25% in deficient group versus 22.2% in sufficient group), there was no significant difference 
regarding hospital mortality rate between the groups.
Conclusion: Statistically significant association was found between low 25(OH)D level 
and increased length of ICU stay in critically ill surgical patients. It could be explained by 
favorable effects of Vitamin D on immune system functions, reducing tissue dysfunction, and 
risk of organ failure and overall complications. However, there was no correlation between 
serum Vitamin D level and patients’ in‑hospital mortality. Further, well‑designed prospective 
clinical studies with adequate sample size are needed to evaluate correlation between serum 
Vitamin D level and mortality in critically ill patients.


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