Vitamin D Deficiency and Clinical Outcomes in Adult Burn Patients: A Systematic Review and Meta-Analysis

Vitamin D deficiency is highly prevalent among burn patients and may impair immune function, inflammation control, and wound healing. To clarify its clinical impact, we conducted a systematic review and meta-analysis of observational studies evaluating outcomes stratified by baseline vitamin D status in adult burn patients. Six endpoints were analyzed: wound infection or cellulitis, bacteremia or septicemia, intensive care unit (ICU) admission, mechanical ventilation, ICU length of stay (LOS), and total hospital LOS. Random-effects models generated pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% CI. Five studies comprising 1,814 patients met the inclusion criteria. Vitamin D sufficiency was associated with significantly reduced odds of bacteremia or septicemia (OR 0.21; 95% CI 0.10-0.43; p<0.0001) and shorter ICU (WMD -5.5 days; p=0.04) and hospital LOS (WMD -5.7 days; p=0.003). A borderline reduction in mechanical ventilation was also observed (OR 0.55; p=0.05), whereas ICU admission and wound infection outcomes showed non-significant trends favoring sufficiency. Heterogeneity varied across outcomes, with the bacteremia analysis demonstrating no heterogeneity (I²=0%). Vitamin D deficiency appears associated with increased systemic infection risk and prolonged hospitalization following burn injury, supporting further prospective trials to evaluate vitamin D supplementation in burn care.