Baseline hypovitaminosis D is not associated with poor clinical outcomes in osteoarticular infections

Details

• Alternative Title:
  Int J Infect Dis
• Personal Author:
  Marschall, J. ; Lewis, J.W.S. ; Warren, D.K. ; Babcock, H.M. ; Barrack, R.L. ; Fraser, V.J.
• Description:
  Objectives
  
  Although vitamin D is recognized as an important factor in bone health, its role in osteoarticular infections is unclear. We hypothesized that low vitamin D (25-hydroxycholecalciferol) levels are associated with a lower likelihood of treatment success in osteoarticular infections.
  
  Methods
  
  This was a retrospective cohort study of patients with orthopedic infections who had a 25-hydroxycholecalciferol level drawn when their infection was diagnosed. Outcomes were determined at early (3–6 months) and late (≥6 months) follow-up after completing intravenous antibiotics.
  
  Results
  
  We included 223 patients seen during an 11-month period with osteoarticular infections and baseline 25-hydroxycholecalciferol levels. During the initial inpatient management of the infection, hypovitaminosis D was identified and treated. The mean 25-hydroxycholecalciferol level was 23 ± 14 ng/ml; 167 (75%) patients had levels <30 ng/ml. Overall, infection treatment success was 91% (159/174) at early follow-up and 88% (145/164) at late follow-up. 25-Hydroxycholecalciferol baseline levels were similar in those with and without successful clinical outcomes, both at early (25 ± 15 vs. 21 ± 9 ng/ml; p = 0.3) and late follow-up (25 ± 15 vs. 23 ± 16 ng/ml; p = 0.6).
  
  Conclusions
  
  To our knowledge this is the first report on hypovitaminosis D and its impact on outcomes of osteoarticular infections. Hypovitaminosis D was frequent in this cohort. With vitamin D repletion, there was no difference in treatment success whether patients had baseline hypovitaminosis or not.
  
  
• Subjects:
  Adult Aged Anti-Bacterial Agents Arthritis, Infectious Calcifediol Cohort Studies Female Humans Male Middle Aged Osteomyelitis Retrospective Studies Treatment Outcome Vitamin D Vitamin D Deficiency

  More +
• Keywords:
  Cholecalciferol Joint Infection Outcome
• Source:
  Int J Infect Dis. 2014; 26:98-102
• Pubmed ID:
  25025238
• Pubmed Central ID:
  PMC4233280
• Document Type:
  Journal Article
• Funding:
  K12 RR023249/RR/NCRR NIH HHSUnited States/ ; UL1 RR024992/RR/NCRR NIH HHSUnited States/ ; K12 HD001459/HD/NICHD NIH HHSUnited States/ ; UL1 TR000448/TR/NCATS NIH HHSUnited States/ ; U54 CK000162/CK/NCEZID CDC HHSUnited States/ ; KL2 RR024994/RR/NCRR NIH HHSUnited States/ ; 5K12HD001459-13/HD/NICHD NIH HHSUnited States/ ; KL2 TR000450/TR/NCATS NIH HHSUnited States/
• Volume:
  26
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e1124f622957a551f7e86dc61a459fb457a1058af6493cc7e934b1fa208459b8
• Download URL:
  https://stacks.cdc.gov/view/cdc/30177/cdc_30177_DS1.pdf
• File Type:
  [PDF - 177.26 KB ]