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Færre komplikationer, større overlevelse med høj D-vitamin

En undersøgelse har vist, at patienter med et lavt D-vitaminindhold i blodet øger deres risiko for at få alvorlige følgevirkninger eller at dø efter et kirurgisk indgreb, hjertekirurgi undtaget. For hver stigning af D-vitamin i blodet med 5 ng/ml faldt den samlede risiko for dødsfald og komplikationer efter operation med syv procent.

En gruppe forskere ønskede at undersøge i hvilken grad der er en sammenhæng mellem D-vitaminniveauet og alvorlige følgevirkninger som for eksempel en alvorlig hospitalsinfektion samt dødsfald efter en operation. Forskerne analyserede data fra 3500 patienter som alle havde gennemgået en operation i perioden 2005 - 2011, der ikke indbefattede hjertet, og hvor der samtidig forelå data om patienternes D-vitaminniveau omkring operationstidspunktet fra tre måneder før til en måned efter.

Udbredt D-vitaminmangel

Flertallet af  patienter opfyldte ikke minimumskravet for et normalt D-vitaminniveau i blodet som er mere end 30 nanogram per milliliter (ng/ml). Det gennemsnitlige D-vitamin-niveau var 23,5 ng/ ml - mere end 60 procent af patienterne befandt sig på grænsen til D-vitaminmangel (10 til 30 ng/ ml), og næsten 20 procent havde en decideret D-vitaminmangel (mindre end 10 ng/ml).

Patienter med det laveste D-vitaminniveau (mindre end 13 ng/ml) havde den største risiko for at dø eller få alvorlige komplikationer. Dem med et højere D-vitaminniveau (op til 44 ng/ml) havde omkring halvt så stor risiko som dem i den laveste gruppe. Der var en liniær nedsat reduktion i alvorlige komplikationer under hospitalsophold for hver 5 ng/ml øget D-vitamin i blodet. Sammenhængen til lav D-vitamin var kun statistisk signifikant for kardiovaskulære komplikationer, selv om der var "stærke tendenser" for dødelighed og infektioner.

Da undersøgelsen ikke var designet til at afgøre med tilstrækkelig sikkerhed, om der er nogen årsag-virkning-sammenhæng mellem D-vitamin og risikoen for skadelige følgevirkninger, foreslår forskerne derfor, at der laves en større lodtrækningsundersøgelse for at vurdere, om såkaldt præoperativ D-vitamin kan reducere risikoen for alvorlige komplikationer og død efter operationen.

Ref.

Turan A, et al. The Association of Serum Vitamin D Concentration with Serious Complications After Noncardiac Surgery. Anesth Analg, 2014;119(3):603-12.

 

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  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`336μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT DISTINCT a.id, a.title, a.name, a.checked_out, a.checked_out_time, a.note, a.state, a.access, a.created_time, a.created_user_id, a.ordering, a.language, a.fieldparams, a.params, a.type, a.default_value, a.context, a.group_id, a.label, a.description, a.required, a.only_use_in_subform,l.title AS language_title, l.image AS language_image,uc.name AS editor,ag.title AS access_level,ua.name AS author_name,g.title AS group_title, g.access as group_access, g.state AS group_state, g.note as group_note FROM has_fields AS a LEFT JOIN `has_languages` AS l ON l.lang_code = a.language LEFT JOIN has_users AS uc ON uc.id=a.checked_out LEFT JOIN has_viewlevels AS ag ON ag.id = a.access LEFT JOIN has_users AS ua ON ua.id = a.created_user_id LEFT JOIN has_fields_groups AS g ON g.id = a.group_id LEFT JOIN `has_fields_categories` AS fc ON fc.field_id = a.id WHERE ( (`a`.`context` = :context AND (`fc`.`category_id` IS NULL OR `fc`.`category_id` IN (:preparedArray1,:preparedArray2,:preparedArray3)) AND `a`.`access` IN (:preparedArray4,:preparedArray5)) AND (`a`.`group_id` = 0 OR `g`.`access` IN (:preparedArray6,:preparedArray7)) AND `a`.`state` = :state) AND (`a`.`group_id` = 0 OR `g`.`state` = :gstate) AND `a`.`only_use_in_subform` = :only_use_in_subform AND `a`.`language` IN (:preparedArray8,:preparedArray9) ORDER BY a.ordering ASC307μs4.81KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id1.01ms1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id76μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `m`.`id`,`m`.`title`,`m`.`module`,`m`.`position`,`m`.`content`,`m`.`showtitle`,`m`.`params`,`mm`.`menuid` FROM `has_modules` AS `m` LEFT JOIN `has_modules_menu` AS `mm` ON `mm`.`moduleid` = `m`.`id` LEFT JOIN `has_extensions` AS `e` ON `e`.`element` = `m`.`module` AND `e`.`client_id` = `m`.`client_id` WHERE ( ( (`m`.`published` = 1 AND `e`.`enabled` = 1 AND `m`.`client_id` = :clientId AND `m`.`access` IN (:preparedArray1,:preparedArray2)) AND (`m`.`publish_up` IS NULL OR `m`.`publish_up` <= :publishUp)) AND (`m`.`publish_down` IS NULL OR `m`.`publish_down` >= :publishDown)) AND (`mm`.`menuid` = :itemId OR `mm`.`menuid` <= 0) AND `m`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY `m`.`position`,`m`.`ordering`4.61ms261.84KBParams/libraries/src/Cache/Controller/CallbackController.php:51Copy
  • SELECT `a`.`id`,`a`.`title`,`a`.`catid`,`a`.`language`, CASE WHEN CHAR_LENGTH(`a`.`alias`) != 0 THEN CONCAT_WS(':', `a`.`id`, `a`.`alias`) ELSE a.id END AS `slug`, CASE WHEN CHAR_LENGTH(`cc`.`alias`) != 0 THEN CONCAT_WS(':', `cc`.`id`, `cc`.`alias`) ELSE cc.id END AS `catslug` FROM `has_content` AS `a` LEFT JOIN `has_categories` AS `cc` ON `cc`.`id` = `a`.`catid` WHERE `a`.`catid` = :catid AND `a`.`state` = :state AND `a`.`access` IN (:preparedArray1,:preparedArray2) AND (`publish_up` IS NULL OR `publish_up` <= :nowDate1) AND (`publish_down` IS NULL OR `publish_down` >= :nowDate2) AND `a`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY CASE WHEN `a`.`publish_up` IS NULL THEN `a`.`created` ELSE `a`.`publish_up` END DESC15.21ms161.75KBParams/plugins/content/pagenavigation/src/Extension/PageNavigation.php:188Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`297μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT custom_data FROM has_extensions WHERE element = 'yootheme' AND folder = 'system' LIMIT 1170μs536B/templates/yootheme/packages/platform-joomla/src/Storage.php:30Copy
  • SELECT `language`,`id` FROM `has_menu` WHERE `home` = '1' AND `published` = 1 AND `client_id` = 0282μs704B/libraries/src/Language/Multilanguage.php:123Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id289μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id66μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `c2`.`language`,CONCAT_WS(':', `c2`.`id`, `c2`.`alias`) AS `id`,CONCAT_WS(':', `ca`.`id`, `ca`.`alias`) AS `catid` FROM `has_content` AS `c` INNER JOIN `has_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `has_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `has_content` AS `c2` ON `a2`.`id` = `c2`.`id` INNER JOIN `has_categories` AS `ca` ON `c2`.`catid` = `ca`.`id` AND `ca`.`extension` = :extension2 WHERE `c`.`id` = :id AND c2.access IN (1,5) AND c2.language != 'da-DK' AND (c2.publish_up IS NULL OR c2.publish_up <= '2025-04-05 01:08:04') AND (c2.publish_down IS NULL OR c2.publish_down >= '2025-04-05 01:08:04') AND c2.state = 11.39ms4KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug`,( SELECT COUNT(`i`.`id`) FROM `has_content` AS `i` WHERE `i`.`catid` = `c`.`id` AND `i`.`state` = 1 AND `i`.`language` IN (:preparedArray5,:preparedArray6)) AS `numitems` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`17.04ms4.05KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `a`.`id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,CASE WHEN `a`.`publish_up` IS NULL THEN `a`.`created` ELSE `a`.`publish_up` END AS `publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`metadata`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`featured`,`a`.`language`,LENGTH(`a`.`fulltext`) AS `readmore`,`a`.`ordering`,`fp`.`featured_up`,`fp`.`featured_down`,CASE WHEN `c`.`published` = 2 AND `a`.`state` > 0 THEN 2 WHEN `c`.`published` != 1 THEN 0 ELSE `a`.`state` END AS `state`,`c`.`title` AS `category_title`,`c`.`path` AS `category_route`,`c`.`access` AS `category_access`,`c`.`alias` AS `category_alias`,`c`.`language` AS `category_language`,`c`.`published`,`c`.`published` AS `parents_published`,`c`.`lft`,CASE WHEN `a`.`created_by_alias` > ' ' THEN `a`.`created_by_alias` ELSE `ua`.`name` END AS `author`,`ua`.`email` AS `author_email`,`uam`.`name` AS `modified_by_name`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,COALESCE(NULLIF(ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1), 0), 0) AS `rating`,COALESCE(NULLIF(`v`.`rating_count`, 0), 0) AS `rating_count` FROM `has_content` AS `a` LEFT JOIN `has_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `has_users` AS `ua` ON `ua`.`id` = `a`.`created_by` LEFT JOIN `has_users` AS `uam` ON `uam`.`id` = `a`.`modified_by` LEFT JOIN `has_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `has_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `has_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE `a`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`access` IN (:preparedArray3,:preparedArray4) AND `c`.`published` = 1 AND `a`.`state` = :condition AND `a`.`catid` IN (:preparedArray5) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`language` IN (:preparedArray6,:preparedArray7) ORDER BY RAND() ASC LIMIT 1561.72ms279.28KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT MAX(`tag_id`) AS `tag_id`,COUNT(*) AS `count`,MAX(`t`.`title`) AS `title`,MAX(`t`.`access`) AS `access`,MAX(`t`.`alias`) AS `alias`,MAX(`t`.`params`) AS `params`,MAX(`t`.`language`) AS `language` FROM `has_contentitem_tag_map` AS `m` INNER JOIN `has_ucm_content` AS `ucm` ON `m`.`content_item_id` = `ucm`.`core_content_item_id` AND `m`.`type_id` = `ucm`.`core_type_id` INNER JOIN `has_categories` AS `cat` ON `ucm`.`core_catid` = `cat`.`id` INNER JOIN `has_tags` AS `t` ON `tag_id` = `t`.`id` INNER JOIN `has_ucm_content` AS `c` ON `m`.`core_content_id` = `c`.`core_content_id` WHERE `t`.`access` IN (:preparedArray1,:preparedArray2) AND `t`.`published` = 1 AND `cat`.`published` > 0 AND `t`.`language` IN (:preparedArray3,:preparedArray4) AND `m`.`type_alias` = `c`.`core_type_alias` AND `c`.`core_state` = 1 AND (`c`.`core_access` IN (:preparedArray5,:preparedArray6) OR `c`.`core_access` = 0) AND (`c`.`core_publish_up` IS NULL OR `c`.`core_publish_up` = :nullDate2 OR `c`.`core_publish_up` <= :nowDate2) AND (`c`.`core_publish_down` IS NULL OR `c`.`core_publish_down` = :nullDate3 OR `c`.`core_publish_down` >= :nowDate3) GROUP BY `tag_id`,`t`.`title`,`t`.`access`,`t`.`alias` ORDER BY RAND() LIMIT 1586.61ms2.75KBParams/modules/mod_tags_popular/src/Helper/TagsPopularHelper.php:183Copy
  • SELECT `c2`.`language`,`c2`.`id` FROM `has_menu` AS `c` INNER JOIN `has_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `has_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `has_menu` AS `c2` ON `a2`.`id` = `c2`.`id` WHERE `c`.`id` = :id178μs1.44KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `name`,`element` FROM `has_extensions` WHERE `type` = 'plugin' AND `folder` = 'finder' AND `enabled` = 1176μs640B/administrator/components/com_finder/src/Helper/LanguageHelper.php:135Copy
  • SELECT `title` FROM `has_finder_taxonomy` WHERE `parent_id` = 1 AND `state` = 1 AND `access` IN (1,5)132μs584B/administrator/components/com_finder/src/Indexer/Taxonomy.php:314Copy
  • SELECT DISTINCT a.id, a.title, a.name, a.checked_out, a.checked_out_time, a.note, a.state, a.access, a.created_time, a.created_user_id, a.ordering, a.language, a.fieldparams, a.params, a.type, a.default_value, a.context, a.group_id, a.label, a.description, a.required, a.only_use_in_subform,l.title AS language_title, l.image AS language_image,uc.name AS editor,ag.title AS access_level,ua.name AS author_name,g.title AS group_title, g.access as group_access, g.state AS group_state, g.note as group_note FROM has_fields AS a LEFT JOIN `has_languages` AS l ON l.lang_code = a.language LEFT JOIN has_users AS uc ON uc.id=a.checked_out LEFT JOIN has_viewlevels AS ag ON ag.id = a.access LEFT JOIN has_users AS ua ON ua.id = a.created_user_id LEFT JOIN has_fields_groups AS g ON g.id = a.group_id WHERE ( (`a`.`context` = :context AND `a`.`access` IN (:preparedArray1,:preparedArray2)) AND (`a`.`group_id` = 0 OR `g`.`access` IN (:preparedArray3,:preparedArray4)) AND `a`.`state` = :state) AND (`a`.`group_id` = 0 OR `g`.`state` = :gstate) AND `a`.`only_use_in_subform` = :only_use_in_subform AND `a`.`language` IN (:preparedArray5,:preparedArray6) ORDER BY a.ordering ASC2.4ms4.75KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT `title` FROM `has_finder_taxonomy` WHERE `parent_id` = 1 AND `state` = 1 AND `access` IN (1,5)125μs584B/administrator/components/com_finder/src/Indexer/Taxonomy.php:314Copy
  • SELECT SUM(CASE WHEN `a`.`next_execution` <= :now THEN 1 ELSE 0 END) AS due_count,SUM(CASE WHEN `a`.`locked` IS NULL THEN 0 ELSE 1 END) AS locked_count FROM `has_scheduler_tasks` AS `a` WHERE `a`.`state` = 1117μs1.37KBParams/administrator/components/com_scheduler/src/Model/TasksModel.php:466Copy
  • SELECT `session_id` FROM `has_session` WHERE `session_id` = ?234μs1KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:291Copy
  • UPDATE `has_session` SET `data` = ? , `time` = ? WHERE `session_id` = ?2.58ms592BParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:318Copy