Association between preoperative levels of 25-hydroxyvitamin D and hospital-acquired infections after hepatobiliary surgery: A prospective study in a third-level hospital

PLoS One. 2020 Mar 26;15(3):e0230336. doi: 10.1371/journal.pone.0230336. eCollection 2020.

Abstract

Introduction: Evidence implicates vitamin D deficiency in poorer outcomes and increased susceptibility to hospital-acquired infections (HAIs). This study examined the association between serum vitamin D levels and HAIs in a population of hepatobiliary surgery patients.

Methods: Participants in this prospective analytical observational study were patients who underwent hepatobiliary surgery in a tertiary hospital in Aragon, Spain, between February 2018 and March 2019. Vitamin D concentrations were measured at admission and all nosocomial infections during hospitalization and after discharge were recorded.

Results: The mean 25-hydroxyvitamin D concentration of the study population (n = 301) was 38.56 nmol/L, which corresponds to vitamin D deficiency. Higher vitamin D concentrations were associated with a decreased likelihood of developing a HAI in general (p = 0.014), and in particularly surgical site infection (p = 0.026). The risk of HAI decreased by 34% with each 26.2-nmol/L increase in serum vitamin D levels.

Conclusions: Vitamin D levels may constitute a modifiable risk factor for postoperative nosocomial infections in hepatobiliary surgery patients.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Cross Infection / epidemiology*
  • Cross Infection / immunology
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Digestive System Surgical Procedures / adverse effects*
  • Female
  • Gastrointestinal Diseases / surgery
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / immunology
  • Postoperative Complications / microbiology
  • Postoperative Complications / prevention & control
  • Preoperative Period
  • Prospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Surgical Wound Infection
  • Tertiary Care Centers / statistics & numerical data
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / diagnosis*
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / immunology

Substances

  • Vitamin D
  • 25-hydroxyvitamin D

Grants and funding

None of the author have any financial disclosure. We have not received any external financial aid. Authors did not received any extra money for participating in the study.