Clinical rheumatology · 2025
The association between serum 25-hydroxyvitamin D levels and clinical outcomes in Chinese adult inpatients: a retrospective cohort study.
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Wang Jialu, Wang Changsheng, Tang Molian, Lin Weiwei, Zhou Yiquan, Feng Yi, Cui Hongyuan, Xu Renying
Аннотация
OBJECTIVES: Previous studies reported the controvertible association between serum 25-hydroxyvitamin D [25(OH)D] level and clinical outcomes, however, whether serum 25(OH)D level were associated with length of hospital stay (LOS) and mortality remained uncertain.
METHODS: Participants were recruited from three teaching hospitals between January 1, 2018 and October 31, 2022 in Shanghai and Beijing, China. Serum concentration of 25(OH)D and other clinical information was collected from medical records. All participants were classified as following: deficient (< 12 ng/ml), insufficient (12-20 ng/ml), and sufficient (≥ 20 ng/ml) based on serum 25(OH)D levels.
RESULTS: A total number of 17,404 inpatients [10,050 men and 7529 women, aged 63.0 (50.0, 71.0) years] were included in the analysis. Generalized linear model analysis demonstrated that 25(OH)D deficient group had an increase of 1.34 days in LOS compared to the sufficient group (β = 1.34; 95% CI 1.06 ~ 1.62; p < 0.001) after adjusting for potential covariates. For a per standard deviation (SD) increase in 25(OH)D level (≈7.86 ng/ml), LOS decreased by 0.50 days (β = - 0.50; 95% CI - 0.61 ~ - 0.39; p trend < 0.001). The results of the subgroup analysis were consistent with the main results. Multiple logistic regression demonstrated that the risk of mortality in 25(OH)D deficient group was 2.63 times higher than that in the sufficient group (OR = 2.63; 95% CI 1.35 ~ 5.13; p = 0.001) in the fully adjusted model. For a per SD increase in 25(OH)D level, the risk of mortality decreased by 35% (OR = 0.65; 95% CI 0.50 ~ 0.86; p trend < 0.001).
CONCLUSION: Vitamin D deficiency is associated with both longer LOS and increased risk of mortality in hospitalized patients. Keypoints • Among hospitalized adult patients who had their vitamin D levels routinely tested (indicating potential risk factors), a high prevalence (approximately 70%) of vitamin D deficiency or insufficiency was observed. • The increase in serum level of vitamin D was associated with both shorter length of hospital stays and lower risk of mortality.
METHODS: Participants were recruited from three teaching hospitals between January 1, 2018 and October 31, 2022 in Shanghai and Beijing, China. Serum concentration of 25(OH)D and other clinical information was collected from medical records. All participants were classified as following: deficient (< 12 ng/ml), insufficient (12-20 ng/ml), and sufficient (≥ 20 ng/ml) based on serum 25(OH)D levels.
RESULTS: A total number of 17,404 inpatients [10,050 men and 7529 women, aged 63.0 (50.0, 71.0) years] were included in the analysis. Generalized linear model analysis demonstrated that 25(OH)D deficient group had an increase of 1.34 days in LOS compared to the sufficient group (β = 1.34; 95% CI 1.06 ~ 1.62; p < 0.001) after adjusting for potential covariates. For a per standard deviation (SD) increase in 25(OH)D level (≈7.86 ng/ml), LOS decreased by 0.50 days (β = - 0.50; 95% CI - 0.61 ~ - 0.39; p trend < 0.001). The results of the subgroup analysis were consistent with the main results. Multiple logistic regression demonstrated that the risk of mortality in 25(OH)D deficient group was 2.63 times higher than that in the sufficient group (OR = 2.63; 95% CI 1.35 ~ 5.13; p = 0.001) in the fully adjusted model. For a per SD increase in 25(OH)D level, the risk of mortality decreased by 35% (OR = 0.65; 95% CI 0.50 ~ 0.86; p trend < 0.001).
CONCLUSION: Vitamin D deficiency is associated with both longer LOS and increased risk of mortality in hospitalized patients. Keypoints • Among hospitalized adult patients who had their vitamin D levels routinely tested (indicating potential risk factors), a high prevalence (approximately 70%) of vitamin D deficiency or insufficiency was observed. • The increase in serum level of vitamin D was associated with both shorter length of hospital stays and lower risk of mortality.