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Published on: January 5, 2018
Vitamin D Deficiency and Neurologic Outcome After Sudden Cardiac Arrest
Jung-Joon Cha1, Jin Wi1,2
1Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Insights
Severe vitamin D deficiency is linked to poor neurologic outcomes and increased mortality following sudden cardiac arrest (SCA). This highlights vitamin D
Area of Science:
- Cardiology
- Neurology
- Endocrinology
Background:
- Vitamin D deficiency is associated with cardiovascular diseases.
- Sudden cardiac arrest (SCA) is a critical event with significant mortality.
- Neurologic outcome post-SCA is a key determinant of survival quality.
Purpose of the Study:
- To investigate the association between vitamin D levels and neurologic outcome after SCA.
- To determine if vitamin D deficiency predicts mortality in SCA survivors.
- To explore vitamin D's role as a prognostic factor in SCA patients.
Main Methods:
- Prospective cohort study of 163 patients resuscitated from out-of-hospital cardiac arrest.
- Baseline blood samples collected upon hospital admission, including 25(OH)D levels.
- Neurologic outcome assessed using Cerebral Performance Category (CPC) score at 1 month; severe deficiency defined as 25(OH)D <10 ng/mL.
Main Results:
- 59% of patients had a favorable neurologic outcome (CPC 1-2); 41% had an unfavorable outcome (death or CPC 3-5).
- Severe vitamin D deficiency was identified as a poor prognostic factor.
- Multivariate analysis confirmed severe vitamin D deficiency's association with unfavorable neurologic outcome and mortality post-SCA.
Conclusions:
- Vitamin D deficiency is prevalent in SCA survivors.
- Severe vitamin D deficiency is strongly associated with poor neurologic outcomes and increased mortality after SCA.
- Maintaining adequate vitamin D levels may be important for SCA patient recovery.
Background:
Vitamin D deficiency is related to various cardiovascular diseases, including sudden cardiac arrest (SCA). This study investigated the association of vitamin D level with neurologic outcome and mortality after resuscitation from SCA.
Patients And Methods:
We enrolled patients who were successfully resuscitated from out-of-hospital cardiac arrest of presumed cardiac cause in Severance Cardiovascular Hospital as a prospective cohort registry. Baseline blood samples including pH, lactate, and vitamin D were obtained without fluid replacement just after hospital admission. Outcome was assessed by cerebral performance category (CPC) score at 1 month after SCA. Favorable outcome was defined as survival with CPC score of 1 or 2, whereas unfavorable one as death or survival with CPC scores of 3 through 5. Severe vitamin D deficiency was defined as 25(OH)D <10 ng/mL.
Results:
A total of 163 patients were included. Overall 96 (59%) patients had a favorable neurologic outcome, whereas 67 patients (41%) showed unfavorable outcome, including 37 (23%) mortality. Patients with unfavorable outcome were likely to be female and have initial non-shockable rhythm, longer arrest time, severe shock, diabetes, and baseline renal dysfunction. In multivariate analysis, severe vitamin D deficiency was one of the poor prognostic factors of both unfavorable neurologic outcome and mortality after SCA.
Conclusions:
Vitamin D deficiency is very prevalent and strongly associated with both unfavorable neurologic outcome and mortality in patients resuscitated from SCA.
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