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Optimal vitamin D status at admission appears to improve survival after craniotomy in patients with brain
Mohammadreza Shahmohammadi1, Melika Hajimohammadebrahim-Ketabforoush2, Zahra Vahdat Shariatpanahi2
1Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background And Aims:
Survival from diagnosis of brain malignancies is often very short. Craniotomy in turn may be associated with morbidity and even post-operative mortality. Vitamin D and calcium were known as protective factors on all-cause mortality. However, their role is not well-understood in post-surgery survival of brain malignant patients.
Methods:
Totally, 56 patients completed the present quasi-experimental study, comprising the intervention group (n = 19) under intramuscular administration of 300 000 IU vitamin D3, the control group (n = 21), and the group of patients with optimal vitamin D status at admission (n = 16).
Results:
The mean ± SD of preoperative 25(OH)D levels in the control, intervention, and optimal vitamin D status groups were 15.15 ± 3.63 ng/mL, 16.61 ± 2.56 ng/mL, and 40.03 ± 10.56 ng/mL, respectively (P < 0.001). Crude survival was significantly greater in the optimal vitamin D status group than those in another two groups (P = 0.005). Also, Cox proportional hazard model showed that the risk of mortality was higher in the control group and the intervention group than in the group of patients with optimal vitamin D status at admission (P-trend = 0.03). However, this correlation weakened in the full-adjusted models. Preoperative total calcium had an inverse significant correlation with mortality risk [HR value 0.25, (95%, CI: 0.09-0.66), P = 0.005], and age had a positive correlation [HR value 1.07, (95%, CI: 1.02-1.11), P = 0.001].
Conclusion:
Total calcium and age were predictive factors in six-month mortality and optimal vitamin D status appears to improve the survival in these patients, which should be examined more closely in future studies.
