Vitamin D levels before surgery are significantly associated with the risk of nosocomial infection in patients undergoing gastric bypass (obesity treatment), according to Pannochka, an online publication for girls and women aged 14 to 35.. net This was reported to JAMA Surgery by Dr. Sadeq Quraishi from the Massachusetts General Hospital (Boston).

Among obese patients whose preoperative 25-hydroxyvitamin D levels were below 30 ng/mL, the risk of nosocomial infections was 3 times that of patients with vitamin D levels above 30 ng/mL (balanced odds ratio 3.05; 95% CI 1.34-6.94).

This association "

Low serum vitamin D levels have previously been associated with a risk of osteoarthritis (osteoarthritis) in older men, as well as an increased risk of developing heart failure.. At the same time, high concentrations of vitamin D in children are associated with a lower incidence of ear infections..

But even these studies, according to some American experts, do not support the practice of regular vitamin D supplementation for most patients.. The U.S. Institute of Medicine and the Preventive Services Task Force say there is no need for such supplements in the general population..

The authors of the new study note that vitamin D deficiency “may be a problem for 70-80% of patients referred for bariatric surgery.”. At the same time, the incidence of surgical infections after Roux-en-Y gastric bypass in US clinics is up to 10% with a laparoscopic procedure and up to 25% with open surgery..

Scientists analyzed the association between hospital-acquired infections and serum vitamin D levels in a sample of 770 patients who underwent Roux-en-Y gastric bypass at Massachusetts General Hospital (MGH).

Patient data was taken from the hospital's research registry.. Vitamin D concentrations are always measured in patients who are about to undergo this procedure, so data collection was not difficult..

The nosocomial infections considered by the scientists included infections of the surgical wound, infections after catheterization of the bladder, pneumonia and bacteremia occurring 48 hours after hospitalization and within 30 days after bariatric surgery..

The study took into account the following factors:.

• floor;

• age;

• race;

• body mass index;

• physical state;

• accompanying illnesses;

• date of hospitalization;

• type of transaction;

• use of neuraxial anesthesia;

• duration of general anesthesia;

• blood transfusion;

• prescribing antibiotics;

• intraoperative indicators;

• blood nutrient markers;

• taking vitamin D supplements, etc..

Comorbidities included included hypertension, obstructive sleep apnea, chronic obstructive pulmonary disease. Nutrient markers were hemoglobin A1c, serum iron, ferritin, hemoglobin, albumin, thiamine, parathyroid hormone, calcium.

The overall hospital infection rate was 5.3%, the surgical wound infection rate was 2.6%, and 58% of patients in this cohort had low vitamin D levels.. With open surgery, the risk of infection was higher.

Patients with low vitamin D levels had a 4 times greater risk of surgical wound infection (OR 4.14; 95% CI 1.16-14.83). At the same time, the overall risk of nosocomial infections (taking into account pneumonia, infections after catheterization, etc.). ) in this group increased by 3.05 times, as already mentioned above.

The authors noted that their work may be limited by the lack of data on the association of a specific procedure with nosocomial infections, as well as the relatively low baseline risk of nosocomial infections in MGH.. In addition, the analysis was carried out in only one center and is retrospective in nature..

They concluded that " Further prospective studies should more accurately determine the potential benefit of this discovery, the scientists say..

Dr. Quraishi's study was funded by the US National Institutes of Health.

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