Evidence map›Paper›PMID 27330812›Full record

ArticleJournal of intensive care2016

Addition of 25-hydroxyvitamin D levels to the Deyo-Charlson Comorbidity Index improves 90-day mortality prediction in critically ill patients.

Bisundev Mahato, Tiffany M N Otero, Carrie A Holland, Patrick T Giguere, Ednan K Bajwa, Carlos A Camargo, Sadeq A Quraishi

Abstract read
In one paragraph

Article in Journal of intensive care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Bisundev MahatoDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, GRJ 402, Boston, MA USA ; Harvard Medical School, Boston, MA USA ; Department of Anesthesiology & Perioperative Care, University of California - Irvine, Orange, CA USA.
Tiffany M N OteroDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, GRJ 402, Boston, MA USA ; Tufts University School of Medicine, Boston, MA USA.
Carrie A HollandDepartment of Medicine, Massachusetts General Hospital, Boston, MA USA.
Patrick T GiguereDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, GRJ 402, Boston, MA USA.
Ednan K BajwaDepartment of Medicine, Massachusetts General Hospital, Boston, MA USA ; Department of Medicine, Harvard Medical School, Boston, MA USA.
Carlos A CamargoDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA USA ; Department of Medicine, Harvard Medical School, Boston, MA USA ; Department of Epidemiology, Harvard School of Public Health, Boston, MA USA.
Sadeq A QuraishiDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, GRJ 402, Boston, MA USA ; Department of Anaesthesia, Harvard Medical School, Boston, MA USA.

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
Research Training for AnesthetistsT32GM007592 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI STUART A FORMAN · 1985 to 2026
$11.8M
Prospective Cohort Study of Severe Bronchiolitis and Risk of Recurrent WheezingU01AI087881 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI CAMARGO, CARLOS ARTURO · 2011 to 2016
$6.2M
Effects of vitamin D and omega-3 fatty acids on infectious diseases and hCAP18R01AI093723 · NIAID · BRIGHAM AND WOMEN'S HOSPITAL · PI CAMARGO, CARLOS ARTURO · 2011 to 2015
$4.0M
Tufts Clinical and Translational Research InstituteTL1TR001062 · NCATS · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2013 to 2017
$2.1M
NCATS NIH HHS L30 TR001257NCATS NIH HHS TL1 TR001062NCRR NIH HHS UL1 RR025758NIAID NIH HHS R01 AI093723NIAID NIH HHS U01 AI087881NIGMS NIH HHS L30 GM102903NIGMS NIH HHS T32 GM007592
6 · The paper itself

Abstract

backgroundThe Deyo-Charlson Comorbidity Index (DCCI) has low predictive value in the intensive care unit (ICU). Our goal was to determine whether addition of 25-hydroxyvitamin D (25OHD) levels to the DCCI improved 90-day mortality prediction in critically ill patients.

methodsPlasma 25OHD levels, DCCI, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were assessed within 24 h of admission in 310 ICU patients. Receiver operating characteristic curves of the prediction scores, without and with the addition of 25OHD levels, for 90-day mortality were constructed and the areas under the curve (AUC) were compared for equality.

resultsMean (standard deviation) plasma 25OHD levels, DCCI, and APACHE II score were 19 (SD 8) ng/mL, 4 (SD 3), and 17 (SD 9), respectively. Overall 90-day mortality was 19 %. AUC for DCCI vs. DCCI + 25OHD was 0.68 (95 % CI 0.58-0.77) vs. 0.75 (95 % CI 0.67-0.83); p < 0.001. AUC for APACHE II vs. APACHE II + 25OHD was 0.81 (95 % CI 0.73-0.88) vs. 0.82 (95 % CI 0.75-0.89); p < 0.001. There was a significant difference between the AUC for DCCI + 25OHD and APACHE II + 25OHD (p = 0.04) but not between the AUC for DCCI + 25OHD and APACHE II (p = 0.12).

conclusionsIn our cohort of ICU patients, the addition of 25OHD levels to the DCCI improved 90-day mortality prediction compared to the DCCI alone. Moreover, the predictive capability of DCCI + 25OHD was comparable to that of APACHE II. Future prospective studies are needed to validate our findings and to determine whether the use of DCCI + 25OHD can influence clinical decision-making.

Indexed as

25-hydroxyvitamin DICUMortalityVitamin D

Identifiers

PMID27330812
PMCPMC4912797

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.