25(OH)D Status In Children With Sepsis And Its Relationship With Outcomes And Immunity:a Prospective Observational Study

Objective To estimate the 25(OH)D status in children with sepsis in pediatric intensive care unit(PICU)and to examine its relationship with outcomes and immunity.Methods We enrolled one hundred and sixteen children with sepsis admitted to PICU of The First Affiliated Hospital of Guangxi Medical University between February 1st 2015 and August 1st 2016.Serum 25(OH)D was measured with electrochemical luminescence,categorized as sufficiency(>75nmol/L),insufficiency(50-75 nmol/L),deficiency(<50nmol/L).We analyze the 25(OH)D status at admission and its association with clinical datas,28-day mortality.Result(1)Among the 116 children: the prevalence of 25(OH)D deficiency was 44.8%(52/116),the 28-day mortality was 24.1%(28/116).(2)On multivariable analysis: high 25(OH)D levels is a protection factor of outcomes in children with sepsis(RR= 0.979,95%CI =0.963-0.995),high PRISM ?is an independent risk factor of outcomes(RR=1.127,95%CI =1.061-1.197).(3)The median survival time was significantly shorter in 25(OH)D deficiency(20.6d)than sufficiency(25.39d)and insufficiency(23.8d).(4)25(OH)D levels isnot associated with immunoglobulin(IgG?Ig A?IgM)or T lymphocyte subsets(CD4+T?CD8+T ?CD4+T /CD8+T).Conclusion 1.The study results demonstrate that a high prevalence of25(OH)D deficiency in children with sepsis.2.Low 25(OH)D levels is not associated with immunoglobulin or T lymphocyte subsets in children with sepsis.3.25(OH)D status is associated with clinical outcomes in children with sepsis in PICU,high 25(OH)D levels is a protection factor of outcomes in children with sepsis(RR= 0.979,95%CI =0.963-0.995),high PRISM is an independent risk factor of outcomes.