Vitamin D status and surgical outcomes: a systematic review.
Vitamin D status and surgical outcomes: a systematic review.
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DOI：
10.1186/s13037-015-0060-y
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发表时间：
2015
影响因子：
3.7
通讯作者：
Hogan KJ
中科院分区：
文献类型：
--
作者：
Iglar PJ;Hogan KJ
维生素 D 对肌肉骨骼健康的重要性早已得到人们的认可，并且人们正在迅速认识到维生素 D 对健康和疾病具有显着的骨骼外影响。尽管几十年来人们已经能够量化维生素 D 缺乏症的血清标志物，并以低成本和高安全性纠正缺乏症，但维生素 D 状态对术后结果的影响直到最近才被确定为一个令人感兴趣的研究课题。到目前为止，这些数据尚未成为正式审查的主题。因此，我们进行了系统评价，以评估围手术期维生素 D 状态与术后结果之间的关联。截至 2014 年 12 月，检索了 PubMed、Ovid MEDLINE、EMBASE、AMED、CINAHL (EBSCOHost)、Cochrane 系统评价数据库和 PROSPERO 的数据库，查找与维生素 D 和手术相关的研究。初步检索共找到 90 份手稿。应用排除标准后，31 项研究符合纳入条件。 15 项研究采用前瞻性观察设计，3 项使用前瞻性随机方案，13 项报告回顾性数据库询问。本综述的主要发现是，31 项研究中有 26 项 (84%) 报告了维生素 D 水平较低的患者至少有一项具有统计学意义的较差结果。 31 项研究中有 5 项 (16%) 发现没有关联。总之，本综述支持维生素 D 缺乏症与多种手术后不良后果相关的假设。未来的研究应重点关注额外的手术和结果，以及维生素 D 补充剂在改善手术时维生素 D 状态较低的参与者的患者安全方面的作用。
The importance of vitamin D for musculoskeletal health has long been recognized, and awareness of significant extra-skeletal effects in health and disease is rapidly emerging. Although it has been possible for many decades to quantify serum markers of vitamin D deficiency, and to correct deficiency at low cost and with high safety, the influence of vitamin D status on post-surgical outcomes has only recently been identified as a research topic of interest. To the present, these data have not been the subject matter of formal review. Accordingly, we conducted a systematic review to assess the association between perioperative vitamin D status and outcomes after surgery. The databases of PubMed, Ovid MEDLINE, EMBASE, AMED, CINAHL (EBSCOHost), The Cochrane Databases of Systematic Review, and PROSPERO were searched through December, 2014 for studies relating to vitamin D and surgery. The initial search yielded 90 manuscripts. After applying exclusion criteria, 31 studies were eligible for inclusion. Fifteen studies employed prospective observational designs, 3 used prospective randomized protocols, and 13 report retrospective database interrogations. The main finding of the present review is that 26 of 31 studies (84%) report at least one statistically significant worse outcome in patients with low vitamin D status. Five of 31 studies (16%) found no association. In conclusion, this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures. Future studies should focus on additional surgeries and outcomes, and on the role of vitamin D supplementation in the improvement of patient safety in participants with low vitamin D status at the time of surgery.