Vitamin D status in the adult burn population at Concord Hospital

Caroline Nicholls1, Nicola Riley2, Alison Crosbie3 Peter Maitz4

1 Department of Nutrition and Dietetics, Concord Repatriation General Hospital, Hospital Rd, Concord, NSW 2137, caroline.nicholls@sswahs.nsw.gov.au
2 Department of Nutrition and Dietetics, Concord Repatriation General Hospital, Hospital Rd, Concord, NSW 2137, nicola.riley@sswahs.nsw.gov.au
3 Department of Nutrition and Dietetics, Concord Repatriation General Hospital, Hospital Rd, Concord, NSW 2137, alison.crosbie@sswahs.nsw.gov.au
4 NSW Statewide Burn Injury Service, Concord Repatriation General Hospital, Hospital Rd, Concord, NSW 2137, peter.maitz@sydney.edu.au

Vitamin D has emerging roles in pain sensation, pruritis and muscle function. Patients are at potential risk of vitamin D deficiency post burn injury due to reduced vitamin D synthesis in the damaged skin, prolonged hospitalisation and ongoing scar management limiting UV exposure. Vitamin D deficiency has been recognised in paediatric burn patients, however there is limited published evidence in the adult population.

Aim
To determine the prevalence of vitamin D deficiency following severe burn injury.

Methods
A retrospective medical file review of all patients ≥18yo, admitted to the Concord Burns Unit with severe burns (≥20%TBSA) between 2011 and 2015. Patient characteristics, burn demographic data, blood results and prescribed vitamin D supplementation were noted. Patients palliated within 7 days were not included in the analysis. Serum vitamin D deficiency was defined by the Australian and New Zealand Bone and Mineral Society and Osteoporosis Australia.

Results
115 patients met the study criteria, 74% were male with burn area between 20-90% TBSA. Of these, 27 (24%) had a serum vitamin D level measured as part of their burn management either during their hospitalisation or outpatient follow-up. Over half of the patients had a serum vitamin D level <50mmol/L.

Discussion
Although the potential for vitamin D deficiency is recognised, it is currently not well monitored given only 24% of the study population had vitamin D measured, and 56% of them were mildly or moderately deficient. Further research is warranted into monitoring of vitamin D levels and possible supplementation regimens given vitamin D status is a modifiable factor to improve outcomes following burn injury.

Key Words
Vitamin D, Adult burn injury

Biography

Caroline Nicholls has been the Senior Dietitian in Burns at Concord Hospital since 2002. She has experience in Critical Care nutrition and nutrition support. She was involved in establishing the Australasian Burns Dietitian support group, allowing the opportunity for information sharing and multi-centred nutrition research. Caroline was co-author of the Nutrition chapter in the ANZBA Allied Health Practice Guidelines.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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