Screening and Treatment of Vitamin D Deficiency on Hospital Admission: Is There a Benefit for Medical Inpatients?

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• 作者：Lena Grä ; del ; MD^a ; Meret Merker ; BMSc^b ; Beat Mueller ; MD^a ; Philipp Schuetz ; MD ; MPH^a ; ^{schuetzph@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Clinical outcomes ; Medical inpatients ; Vitamin D deficiency
• 刊名：The American Journal of Medicine
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：129
• 期：1
• 页码：116.e1-116.e34
• 全文大小：681 K

文摘

Whether screening and treatment of vitamin D deficiency improves clinical outcomes in medical inpatients remains unclear. We performed a systematic search and summarized the evidence from observational and randomized, controlled studies (RCTs) on the influence of vitamin D deficiency and its treatment on patient outcomes.

Methods

The MEDLINE and EMBASE databases were searched in January 2015 using the terms “vitamin D deficiency,” “vitamin D,” “mortality,” “inpatient,” “length of stay,” “hospitalization,” “accidental falls,” “quality of life,” “activities of daily living,” and “intensive care units.”

Results

Of 239 potential studies, 29 observational studies and 5 RCTs were included. Observational studies revealed an association between vitamin D deficiency and adverse patient outcomes, such as mortality, higher incidence and severity of infections, and increased duration of hospital stay, in the inpatient and geriatric patient population. The RCT data, however, are inconclusive regarding beneficial effects of vitamin D supplementation for reduction of mortality and length of hospital stay, as well as fall prevention.

Conclusions

Despite evidence of associations in observational studies, high-quality evidence from interventional trials on the benefits of vitamin D supplementation in inpatients is currently lacking. On the basis of the available evidence, general vitamin D screening and supplementation for the medical inpatient population in an acute care setting cannot be recommended.