Vitamin D-3 Status of Critically Ill Patients Admitted at ICU with Multidisciplinary Diseases in a Tertiary Care Hospital

Author(s): Mohammad Mostafizur Rahman, Kazi Jahangir Hossain, Mohammad Farhadul Haque, Nasir Uddin Ahmed, Momena Begum, Muhammad Salah Uddin, Shouhardyo Kundu, Sukalyan Kumar Kundu

Introduction: Vitamin D is necessary to maintain serum calcium concentration within the normal physiologic range for musculoskeletal health. Vitamin D deficiency in children causes rickets and prevents children from reaching their maximum bone mass and genetically determined height. In adults, vitamin D deficiency causes abnormal mineralization of the collagen matrix in bone, known as osteomalacia. Usually the Survivors of critical illness are at risk for subsequent hospitalization, outpatient evaluation, and related health care costs. Moreover, recent studies showed that vitamin D deficiency among critically ill patients increased the rate of mortality. Therefore, this paper desired to determine the vitamin D-3 status according to demographic characteristics of critically ill patients admitted at ICU with multidisciplinary diseases.

Objective: The aim of this paper was to determine the vitamin D-3 status according to demographic characteristics of critically ill patients admitted at ICU with multidisciplinary diseases.

Methodology: This was a descriptive cross-sectional study conducted at the Intensive Care Unit (ICU) in Shaheed Monsur Ali Medical College and Hospital, Uttara Dhaka, Bangladesh during July, 2023 to October, 2023. A total of 243 critically ill patients admitted at ICU with multidisciplinary diseases were purposively enrolled in this study. An international standard approach was used to determine the vitamin D-3 level of the study patients. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) software, version 23.0. The ethical clearance of this study was obtained from the Ethics Committee of Shaheed Monsur Ali Medical College and Hospital, Uttara Dhaka, Bangladesh.

Results: A total of 243 critically ill patients at any age admitted at ICU with multidisciplinary diseases were enrolled in this study. Among the patients, 11(4.52%) were children and 232(95.47%) were adults. Among the children, male were 7(63.63%) and female were 4(36.36%) while in the adults, male were 123(53, 01%) and female were 109(46.98%). Among the children, 9(81.81%) were from urban area while 2(18.18%) children were from rural area of Bangladesh. Among the adults, 145(62.5%) were from urban area and 87(37.5%) were from rural area of Bangladesh. The mean age of the study patients was 46.55±19.60 years. In the adults, the vitamin D-3 level were observed deficiency 208(89.66%), insufficiency 18(7.75%), sufficiency 6(2.58%) and there was no toxicity and the most deficiency prevalent age group (38-57) years. In the male adults, the vitamin D-3 level were observed 111(47.84%) deficiency, 9(3.87%) insufficiency and 3(1.29%) sufficiency while among the female adults, 97(41.81%) deficiency, 9(3.87%) insufficiency and 3(1.29%) sufficiency .and there was no toxicity in both the gender. According to residence distribution, the urban adults had 129(55.68%) deficiency, 11(4.74%) insufficiency and 5(2.15%) sufficiency while in rural adults had 79(34.05%) deficiency, 7(3.01%) insufficiency, 1(0.43%) sufficiency and no toxicity was observed among the urban and rural adults. Among the children, 6(54.54%) had deficiency and followed by 5(45.45%) insufficiency and 0(0%) sufficiency. The most vitamin D-3 deficiency prevalent child age group was (14-17) years. Among the male children, 4(36.36%) had deficiency, and followed by 3(27.27%) insufficiency and 0(0%) sufficiency while in female children, 2(18.18%) had deficiency, 2(18.18%) insufficiency and 0(0%) sufficiency. 5(45.45%) urban children had deficiency, 4(36.36%) insufficiency and 0(0%) sufficiency while 1(9.09%) rural children had deficiency, 1(9.09%) insufficiency and 0(0%) sufficiency.

Conclusion: This study investigated 89.66 % critically adult ill patients at ICU had vitamin D-3 deficiency and at the same time 54.54% critically ill children admitted at ICU had vitamin D-3 deficiency which may increase the rate of mortality. So, this study emphasises on vitamin-3 status investigation and there by its supplementation for the critically ill patients at ICU to decrease the rate of mortality in Bangladesh.