Faculty Articles

Effects of Vitamin D Deficiency in Aneurysmal Subarachnoid Hemorrhage



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Critical Care Medicine





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Lippincott Williams & Wilkins

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Learning Objectives: Vitamin D deficiency has been associated with increased risk and adverse outcomes in many clinical settings including cardiovascular disease, stroke, and critically ill patients. Therefore we aimed to determine whether vitamin D deficiency (≤20ng/mL) had any effect in aneurysmal subarachnoid hemorrhage (aSAH) outcomes including mortality, vasospasm, hydrocephalus, and hospital acquired infections.

Methods: A retrospective record review was conducted in a tertiary community hospital in Puerto Rico. All records of adult patients admitted to the neurosurgical intensive care unit (NICU) with a diagnosis of aSAH from January 2013 to July 2014 were reviewed. Patients with a 25-hydroxyvitamin-D level drawn during admission were included in the analysis.

Results: A total of 40 patients were admitted with a diagnosis of aSAH during the study period and 33 met the inclusion criteria. Overall, 81% (n=27) of patients were vitamin D deficient or insufficient (<30ng/mL). Subjects were grouped into those with vitamin D deficiency (n=13, 39%) and those without (n=20, 61%). Except for a larger prevalence of a history of coronary artery disease, all other demographic, and baseline clinical parameters were the same across groups. No significant difference in hospital mortality was observed between groups (2 (15.4%) vs 5 (25%) p = 0.676). The rate of vasospasm and vasopressor use was also similar (p = 0.95 for both). Although there was an increased use of intra-arterial nicardipine in patients with vitamin D deficiency it was not statistically different across groups (p=0.446). No difference was found in the rates of hydrocephalus requiring external ventricular drain or infections (p=0.46 and p=0.56, respectively).

Conclusions: There is a high prevalence of vitamin D deficiency and insufficiency among patients admitted with a diagnosis of aSAH. Despite this no difference in clinical outcomes was observed in patients when compared by vitamin D group. Further studies with a larger sample size should be conducted to assess any potential effects of vitamin D levels in this patient population.


Medicine and Health Sciences | Pharmacy and Pharmaceutical Sciences


aneurysmal subarachnoid hemorrhage, Puerto Rico, vitamin D deficiency


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