Association between Vitamin D deficiency and Neurologic Outcomes in Patients after Cardiopulmonary Resuscitation

Abstract

Aim: We investigated the association between vitamin D deficiency and neurologic outcomes after cardiopulmonary resuscitation.

Method: Data from the prospective cardiac arrest registry in the emergency department between October 2019 and April 2021 were retrospectively analyzed. Blood samples were obtained during cardiopulmonary resuscitation wherein 25-hydroxyvitamin D serum levels were analyzed; deficiency was defined as levels < 10 ng/mL. The primary outcome was neurologic outcomes at 3 months assessed using the modified Rankin Scale.

Result: A total of 195 patients (mean age, 64.5 ± 16.1 years; 135 [69.2%] men) were included. A significantly greater proportion of patients with poor outcomes had vitamin D deficiency compared with those with good outcomes (49.4% vs. 18.2%, P = 0.001). The area under the curve for a sustained return of spontaneous circulation and 3-month poor neurologic outcomes was 0.595 (P = 0.031) and 0.704 (P < 0.001), respectively. In a multivariate analysis, vitamin D deficiency (odds ratio [OR]: 10.22; 95% confidence interval [CI]: 1.47-70.82, P = 0.019), initial shockable rhythm (OR: 0.03; 95% CI: 0.00-0.84, P = 0.040), low flow time (OR: 1.10; 95% CI: 1.03-1.16, P = 0.003), and thrombocytopenia (OR: 10.66; 95% CI: 1.13-100.41, P = 0.039) were significantly associated with 3-month poor neurologic outcomes.

Conclusion: The prevalence of vitamin D deficiency in patients with cardiac arrest was 44% and was associated with poor neurological outcomes at 3 months.