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Original Article
- Micronutrient deficiencies in copper, zinc, and vitamin D as predictors of clinical outcomes in critically ill surgical patients in Korea: a retrospective cohort study
- Jiae Kim, Yanghee Jun, Ye Rim Chang, Jong-Kwan Baek, Hak-Jae Lee, Hyewon Han, Suk-Kyung Hong
- Ann Clin Nutr Metab 2024;16(3):158-167. Published online December 1, 2024
- DOI: https://doi.org/10.15747/ACNM.2024.16.3.158
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Abstract
PDF - Purpose: To investigate the prevalence of copper, zinc, and vitamin D deficiencies in surgical intensive care unit (SICU) patients and the associations between those deficiencies and clinical outcomes.
Methods: We conducted a retrospective study of 210 patients admitted to the SICU of Asan Medical Center between June 2020 and June 2022. Micronutrient levels were measured within 7 days of SICU admission. Primary outcomes were the mortality rate, length of SICU stay, hospital stay duration, and mechanical ventilation duration.
Results: Copper deficiency was found in 35% (68/193), zinc deficiency in 52% (100/193), and severe vitamin D deficiency in 46% (82/179) of patients. Copper-deficient patients showed a significantly higher mortality rate (25.0% vs. 12.8%, P=0.044), longer hospital stays (57.8±47.0 vs. 45.2±36.6 days, P=0.041), and extended mechanical ventilation duration (26.9±23.3 vs. 18.8±15.7 days, P=0.012). Zinc deficiency was associated with higher C-reactive protein levels (16.2±9.5 vs. 11.5±8.8 mg/dL, P=0.001) and lower prealbumin levels (6.5±2.8 vs. 9.9±5.6 mg/dL, P<0.001). Severe vitamin D deficiency (<10 ng/mL) was not significantly associated with mortality or other clinical outcomes (mortality: <10 ng/mL vs. ≥10 ng/mL, 13% vs. 18%, P=0.583).
Conclusion: Micronutrient deficiencies are prevalent in SICU patients. Copper deficiency significantly correlated with poor clinical outcomes, and zinc deficiency showed a strong association with inflammatory markers. Early assessment and supplementation of micronutrients could be beneficial for critically ill surgical patients.
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Review Article
- Vitamin D Deficiency in Critically Ill Patients
- Ji Hyun Lee, Jae-Myeong Lee
- Surg Metab Nutr 2017;8(2):17-22. Published online December 30, 2017
- DOI: https://doi.org/10.18858/smn.2017.8.2.17
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Abstract
PDF
Vitamin D deficiency is a commonly observed global phenomenon in both the general population as well as hospitalized patients, especially critically ill patients. Many studies have demonstrated an association between vitamin D deficiency and risk of chronic diseases, including cardiovascular disease, diabetes, cancers, autoimmune diseases, and infectious diseases. Vitamin D deficiency is also associated with multiple adverse health outcomes, including increased morbidity and mortality in critically ill patients. The purpose of this review article is to present the current knowledge of clinical outcomes as well as the positive and adverse effects of vitamin D supplements on the relationship between vitamin D status and critical illness. In addition, future strategies for dealing with vitamin D deficiency are suggested.
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