Research Reports - Vitamin D deficiency in traumatic brain injury and its relationship with severity of injury and quality of life

J Neurotrauma. 2016 Dec 20. doi: 10.1089/neu.2016.4494. [Epub ahead of print]

Toman E(1), Bishop JR(2), Davies DJ(3), Su Z(4), Criseno S(5), Mason A(5),
Toogood AA(5), Belli A(6).

This single-center prospective observational study aims to describe the
prevalence of vitamin D deficiency (VDD) in the traumatic brain injury (TBI)
population and identify any relationship between vitamin D and severity of head
injury or quality of life. One hundred twenty-four TBI patients had serum vitamin
D (25-OHD) levels measured at the local post-TBI endocrine screening clinic over
20 months. Quality of Life after Brain Injury questionnaires were completed by
the patient concurrently. A multivariate regressional analysis was performed,
controlling for age, season, ethnicity, time since injury, TBI severity, and
gender. A total of 34% (n = 42) of the cohort were vitamin D deficient (25-OHD
<25 nmol/L), with a further 23% (n = 29) having insufficient levels (25-OHD
25-50 nmol/L). Vitamin D was significantly lower in patients with severe TBI than
in patients with mild TBI (n = 95; p = 0.03; confidence interval [CI] 95% -23.60
to -1.21; mean effect size 12.40 nmol/L). There was a trend for self-reported
quality of life to be better in patients with optimum vitamin D levels than in
patients with deficient vitamin D levels, controlling for severity of injury
(n = 81; p = 0.05; CI 95% -0.07 to 21.27). This is the first study to identify a
significant relationship between vitamin D levels and severity of head injury.
Clinicians should actively screen for and treat VDD in head-injured patients to
reduce the risk of further morbidity, such as osteomalacia and cardiovascular
disease. Future research should establish the natural history of vitamin D levels
following TBI to identify at which stage VDD develops and whether vitamin D
replacement could have a beneficial effect on recovery and quality of life. 

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