Dr Jason Diab1, Dr David Khaicy1, Dr Fergus Davidson1, Prof Peter Maitz1, Dr Winnie Hong1
1Concord Hospital, Concord, Australia
Vitamin D deficiency is observed in critically ill patients and has been related to limited sunlight exposure or the magnitude of injury. It is associated with calcium homeostasis and bone mineralization, osteopenia, osteoporosis, and fractures . It has gained considerable amount of interest in the medical literature and the effects of vitamin D on health outcomes are still unclear. In specific subpopulations such as burns, the hypercatabolic response and systemic inflammatory response (SIRS) poses a dynamic response from the body that in turn reduces vitamin D, carrier proteins and albumin . The aim is to discuss current understanding of vitamin D and its role in burn patients, the effect of burn injury on vitamin D status, the association of vitamin D levels on outcome and the potential therapeutic value of vitamin D.
A comprehensive literature review was conducted to obtain an understanding of the context, followed by a retrospective audit at Concord hospital from 2017 – 2019. Adult in patients whom suffered a burn were included in the study. Data was obtained from demographic information, severity of burn, medication use and vitamin D status. SPSS was used to analyse data.
Patients admitted to the unit over the two year period did not all have vitamin D levels measured. Although, there is variation in the types of burns and length of stay, in the most severe burns there levels were reduced over an extended period of admission. The statistical relationship regarding this outcome is pending.
There may be contributing factors to vitamin D deficiency in patients with severe burns including pre-exisiting deficiency, prolonged hospitalization and lack of sun exposure. The role of Vitamin D is equivocal at this stage with ongoing research needed.
Jason is a SRMO at Concord Burn Unit with an interest in public health prevention and epidemiology in burns.