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Free Content Relationship between serum vitamin D concentrations and clinical outcome of community-acquired pneumonia

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SETTING: Hospitalised patients with community-acquired pneumonia (CAP) in a tertiary referral hospital in South Korea.

OBJECTIVE: To determine the burden of vitamin D deficiency in patients hospitalised with CAP and to investigate whether vitamin D deficiency affected clinical outcomes.

DESIGN: Serum 25-hydroxyvitamin D (25[OH]D) levels were measured at admission; vitamin D deficiency was defined as 25(OH)D <20 ng/ml. Data were retrospectively analysed for incidence of vitamin D deficiency. The primary outcome was the relationship between serum vitamin D concentration and 28-day all-cause mortality in CAP.

RESULTS: The mean age was 68.1 years (standard deviation [SD] ± 14.6), and the mean pneumonia severity index was 98.0 (±SD 28.6). Of the 797 patients (males 66.0%), 641 (80.4%) had vitamin D deficiency. Overall mean serum 25(OH)D level was 14.0 ± 7.4 ng/ml. The 28-day all-cause mortality rate in vitamin D-deficient patients was significantly higher than in non-deficient patients (8.3% vs. 2.6%, P = 0.01), and serum vitamin D level was negatively associated with risk of 28-day mortality in CAP after adjustment for pneumonia severity index and serum lactate levels (OR 0.94, 95%CI 0.90–0.99, P < 0.01).

CONCLUSION: The prevalence of vitamin D deficiency was ~80% in patients hospitalised with CAP. Vitamin D deficiency was also a significant predictor of increased 28-day all-cause mortality.
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Keywords: 25(OH)D; calcifediol; pneumonia severity index; vitamin D deficiency

Document Type: Research Article

Affiliations: 1: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea 2: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Regional Respiratory Center, Yeungnam University Hospital, Daegu, South Korea 3: Department of Internal Medicine, The Catholic University of Korea College of Medicine, Uijeongbu St Mary's Hospital, Uijeongbu, South Korea

Publication date: June 1, 2015

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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