ASSOCIATION OF SERUM VITAMIN D LEVELS AND SEVERITY OF SEPSIS

BACKGROUND Sepsis is a leading cause of death among critically ill patients in non-coronary intensive care units. Vitamin D is a key regulator of innate and adaptive immune systems that may influence host susceptibility to infection. It enhances the body's first line defence against microbes, which cause sepsis. The aim of the study was to investigate the association between Vitamin D level and severity of sepsis and its outcome. MATERIALS AND METHODS A case-control study was conducted in the Department of Medicine of SCB Medical College, Cuttack. Sixty adult patients of sepsis and sixty age and sex matched healthy controls were included in the study. Patients were categorised into sepsis, severe sepsis and septic shock. 25(OH) D level was estimated in all the patients and controls. The outcome of the patients, either discharged or death was recorded and the level of Vitamin D was correlated with the severity and outcome of the patients. RESULTS Out of 59 cases who completed the study, 33 (56%) had sepsis, 15 (25%) had severe sepsis and 11 (15%) were in septic shock at presentation. Vitamin D insufficiency was seen in 88.14% of cases and 70% of healthy controls. Mean 25(OH) vitamin D level was found to be 13.87 +/- 11.4 ng/mL in cases and 20.7 +/- 12.4 ng/mL in controls, which was statistically significant (p=0.002). 25(OH) D insufficiency was found in all the 11 (100%) cases of septic shock, 93% of severe sepsis and 82% of sepsis patients at presentation. Eleven cases died during treatment and all of them had Vitamin D insufficiency. No mortality was found in patients with sufficient vitamin D level. CONCLUSION Patients of sepsis with low vitamin D level was associated with severe sepsis, septic shock, higher mortality rate and poor outcome.