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- Title
Venous Thromboembolism is Associated With Lack of Vitamin D Supplementation in Patients With Spinal Cord Injury and Low Vitamin D Levels.
- Authors
Ehsanian, Reza; Timmerman, Molly A.; Wright, Jerry M.; McKenna, Stephen; Dirlikov, Ben; Crew, James
- Abstract
<bold>Background: </bold>The role of vitamin D in the pathogenesis of venous thromboembolism (VTE) and prevalence of low vitamin D (LVitD) in spinal cord injury (SCI) has motivated vitamin D testing and supplementation. This is an exploratory study of data collected at a time before the routine clinical practice of vitamin D supplementation, allowing for evaluation of the natural history of vitamin D levels in patients with SCI.<bold>Objective: </bold>To determine if vitamin D supplementation in persons with SCI and LVitD levels is associated with decreased prevalence of VTE.<bold>Design: </bold>Retrospective cohort study.<bold>Setting: </bold>Rehabilitation Center at a Level I Trauma Center.<bold>Participants: </bold>Patients with SCI admitted to acute inpatient rehabilitation (N = 282).<bold>Main Outcome Measures: </bold>VTE prevalence in patients with LVitD levels, grouped by presence or absence of vitamin D supplementation.<bold>Results: </bold>Of the acute inpatient SCI population, 80% (227/282) of patients demonstrated vitamin D levels <30 ng/mL (LVitD). Although the incidence of VTE was almost double in the LVitD group, 19% (43/227) of the patients in the LVitD group had VTE versus 9% (5/55) of patients with vitamin D levels ≥30 ng/mL (normal VitD [NVitD]); this difference was not statistically significant (P = .108, Cramer's V = .104). When the role of vitamin D supplementation was analyzed, individuals in the LVitD group who received no vitamin D supplementation (LVitDSuppNegative) had a higher incidence of VTE (statistically significant) compared to the LVitD group with vitamin D supplementation (LVitDSuppPositive) (24% [42/178] vs. 2% [1/49]) (P < .001, Cramer's V = .226). In post hoc exploratory analyses, the VTE rate of patients in the LVitDSuppNegative group was noted to be significantly higher than that in all other patient groups combined (P < .001, Cramer's V = .229). A binary logistic regression model incorporating clinical covariates also showed this grouping to be significant.<bold>Conclusion: </bold>A significant association appears to exist between lack of vitamin D supplementation and VTE occurrence in persons with acute SCI and LVitD levels.<bold>Level Of Evidence: </bold>III.
- Subjects
UNITED States; DIETARY supplements; LONGITUDINAL method; PROGNOSIS; SPINAL cord injuries; THROMBOEMBOLISM; VEINS; VITAMIN D; VITAMIN D deficiency; DISEASE incidence; DISEASE prevalence; RETROSPECTIVE studies; BLOOD; DISEASE complications
- Publication
PM & R: Journal of Injury, Function & Rehabilitation, 2019, Vol 11, Issue 2, p125
- ISSN
1934-1482
- Publication type
journal article
- DOI
10.1016/j.pmrj.2018.09.038