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Article

Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder—A Nationwide Study

1
Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
2
Department of Internal Medicine, Lenox Hill Hospital, Northwell Health, New York, NY 10075, USA
3
siParadigm Diagnostic Informatics, Pine Brook, NJ 07058, USA
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Pramukhswami Medical College, Shree Krishna Hospital, Anand, Gujarat 388325, India
5
Department of Internal Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab 143501, India
6
Department of Internal Medicine, Larkin Community Hospital, Hialeah, FL 33012, USA
7
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
8
Brooklyn Cancer Care, Brooklyn, NY 11203, USA
9
Department of Internal Medicine, Oba Okunade Sijuade College of Medicine, Igbinedion University Okada, Edo State 23401, Nigeria
10
Medical University of Americas, Devens, MA 01434, USA
11
Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
12
Department of Internal Medicine, Advent Health Orlando, Orlando, FL 32803, USA
13
Department of Internal Medicine, Guthrie Robert Packer hospital, Sayre, PA 18840, USA
14
Department of Neurology, Stormont Vail Health, Topeka, KS 66604, USA
*
Author to whom correspondence should be addressed.
U.P. and S.Y. contributed equally.
Received: 24 October 2020 / Revised: 8 November 2020 / Accepted: 19 November 2020 / Published: 22 November 2020
(This article belongs to the Section Cardiology and Vascular Disease)
Background: According to past studies, recovery and survival following severe vascular events such as acute myocardial infarction and stroke are negatively impacted by vitamin D deficiency. However, the national estimate on disability-related burden is unclear. We intend to evaluate the prevalence and outcomes of vitamin D deficiency (VDD) among patients with cardiovascular disease (CVD) and cerebrovascular disorder (CeVD). Methods: We performed a cross-sectional study on the Nationwide Inpatient Sample data (2016–2017) of adult (≥18 years) hospitalizations. We identified patients with a secondary diagnosis of VDD and a primary diagnosis of CVD and CeVD using the 9th revision of the International Classification of Diseases, clinical modification code (ICD-10-CM) codes. A univariate and mixed-effect multivariable survey logistic regression analysis was performed to evaluate the prevalence, disability, and discharge disposition of patients with CVD and CeVD in the presence of VDD. Results: Among 58,259,589 USA hospitalizations, 3.44%, 2.15%, 0.06%, 1.28%, 11.49%, 1.71%, 0.38%, 0.23%, and 0.08% had primary admission of IHD, acute MI, angina, AFib, CHF, AIS, TIA, ICeH, and SAH, respectively and 1.82% had VDD. The prevalence of hospitalizations due to CHF (14.66% vs. 11.43%), AIS (1.87% vs. 1.71%), and TIA (0.4% vs. 0.38%) was higher among VDD patients as compared with non-VDD patients (p < 0.0001). In a regression analysis, as compare with non-VDD patients, the VDD patients were associated with higher odds of discharge to non-home facilities with an admission diagnosis of CHF (aOR 1.08, 95% CI 1.07–1.09), IHD (aOR 1.24, 95% CI 1.21–1.28), acute MI (aOR 1.23, 95% CI 1.19–1.28), AFib (aOR 1.21, 95% CI 1.16–1.27), and TIA (aOR 1.19, 95% CI 1.11–1.28). VDD was associated with higher odds of severe or extreme disability among patients hospitalized with AIS (aOR 1.1, 95% CI 1.06–1.14), ICeH (aOR 1.22, 95% CI 1.08–1.38), TIA (aOR 1.36, 95% CI 1.25–1.47), IHD (aOR 1.37, 95% CI 1.33–1.41), acute MI (aOR 1.44, 95% CI 1.38–1.49), AFib (aOR 1.10, 95% CI 1.06–1.15), and CHF (aOR 1.03, 95% CI 1.02–1.05) as compared with non-VDD. Conclusions: CVD and CeVD in the presence of VDD increase the disability and discharge to non-home facilities among USA hospitalizations. Future studies should be planned to evaluate the effect of VDD replacement for improving outcomes. View Full-Text
Keywords: vitamin D deficiency; ischemic heart disease; atrial fibrillation; congestive heart failure; myocardial infarction; ischemic stroke; hemorrhagic stroke; transient ischemic attack; nationwide inpatient sample vitamin D deficiency; ischemic heart disease; atrial fibrillation; congestive heart failure; myocardial infarction; ischemic stroke; hemorrhagic stroke; transient ischemic attack; nationwide inpatient sample
MDPI and ACS Style

Patel, U.; Yousuf, S.; Lakhani, K.; Raval, P.; Kaur, N.; Okafor, T.; Shah, C.; Singh, H.; Martin, M.; Nwodika, C.; Yogarajah, A.; Rakholiya, J.; Patel, M.; Chakinala, R.C.; Shah, S. Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder—A Nationwide Study. Medicines 2020, 7, 72. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines7110072

AMA Style

Patel U, Yousuf S, Lakhani K, Raval P, Kaur N, Okafor T, Shah C, Singh H, Martin M, Nwodika C, Yogarajah A, Rakholiya J, Patel M, Chakinala RC, Shah S. Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder—A Nationwide Study. Medicines. 2020; 7(11):72. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines7110072

Chicago/Turabian Style

Patel, Urvish, Salma Yousuf, Komal Lakhani, Payu Raval, Nirmaljot Kaur, Toochukwu Okafor, Chail Shah, Harmandeep Singh, Mehwish Martin, Chika Nwodika, Angelina Yogarajah, Jigisha Rakholiya, Maitree Patel, Raja C. Chakinala, and Shamik Shah. 2020. "Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder—A Nationwide Study" Medicines 7, no. 11: 72. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines7110072

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