ASSOCIATION OF VITAMIN D LEVELS AND MORTALITY IN CRITICALLY ILL CHILDREN – A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Vitamin D is a fat-soluble vitamin that plays an important role in bone health but also has effects on immune regulation. Critically ill children are often at risk of vitamin D deficiency due to limited sun exposure, impaired nutrition, and disease-induced metabolic disturbances.

Aims & Objectives

• To assess the vitamin D levels in critically ill children
• To correlate the vitamin D levels with PRISM III scores as a predictor of mortality in critically ill children.
• To correlate vitamin D deficiency with the duration of hospital stay

Methods:

• Study Design: prospective observational study
• Duration: May 2023 to October 2024 (18 months).
• Participants: All critically ill children aged between 1 year and 18 years who were admitted to the PICU in Ramaiah Hospital
• Exclusion Criteria: Known cases of thyroid or parathyroid disorders, chronic renal failure, liver diseases, on medications that affect vitamin D levels and those not consenting to participate.
• Procedures: 3 ml of blood was collected from each subject for the assessment of serum vitamin D levels using enhanced chemiluminescence method on Ortho Clinical Diagnostics VITROS 5600 analyser.
• Data Analysis: Data was entered into Microsoft Excel and analysed using SPSS Version 22. Descriptive statistics such as means, standard deviations, and frequencies were used to summarise the data. Chi-square tests or Fisher’s exact tests were applied to analyse the association between categorical variables. For continuous data, the t-test or Mann-Whitney U test was used, depending on the distribution of the data. Graphs and charts were generated using MS Excel to visualise the distribution of key variables. Pearson’s or Spearman’s correlation tests were performed to identify any correlations between vitamin D levels and clinical outcomes. Statistical significance was set at p < 0.05.
• Sample Size: 167 subjects.

Results:

Out of the total 167 participants, 37(n) 22.2% were vitamin D deficient, 41(n) 24.6% had insufficient levels, and 89(n) 53.3% had sufficient vitamin D levels. Overall, 19(n) 11.4% of the participants died, while 148(n) 88.6% survived. In terms of hospital stay, 105(n) 62.9% were discharged within 5 days, whereas 62(n) 37.1% had a prolonged ICU stay exceeding 5 days.

Conclusion:

This study reveals that baseline vitamin D concentration showed no significant association with illness severity, ICU stay, or mortality.

These findings suggest that vitamin D status alone is not an independent prognostic marker in paediatric critical illness.
Routine screening may still be beneficial for overall nutritional management and immune support in this vulnerable population