Preliminary Observation On The Relationship Between Serum 25(OH)D Level And Death In Severe Multiple Trauma Patients

Objective: To provide a new theoretical basis for the treatment of patients with severe multiple trauma by observing the serum level of 25-hydroxyvitamin D(25(OH)D)in the early postinjury period of patients with severe multiple trauma and analyzing the correlation between 25(OH)D and death.Methods: The type of this study is a prospective and observational study.The subjects of this study were patients with severe multiple trauma in the EICU of the affiliated hospital of zunyi medical college from February 2018 to November 2018.Basic information of the patients was collected and indexes of 25(OH)D,fasting plasma glucose and related glucose metabolism were tested in the next morning after admission.Mechanical ventilation time was recorded,and the length of stay in the EICU and hospital death data of 28 days were followed up.The correlation between 25(OH)D and fasting plasma glucose,related glucose metabolism indexes,trauma severity score,mechanical ventilation time and the length of stay in the EICU was analyzed.The patients were divided into survival group and death group according to whether they died within 28 days in hospital,and the differences in Age,sex,ISS score,APACHEII score,GCS score,25(OH)D,FPG,Fins,and C-P were compared between the two groups.Factors with statistically significant differences in univariate analysis were included in the multivariate Logistic regression model to evaluate the independent correlation between 25(OH)D and death of patients with severe multiple trauma.Results: A total of 121 patients with severe multiple trauma were included,79.3% of whom were male.102 cases survived and 19 died,and the fatality rate during hospitalization was 15.7%.The average serum 25(OH)D level was 17.63±6.97ng/ml.Serum 25(OH)D level was negatively correlated with ISS score,APACHEII score,FPG,Fins,mechanical ventilation time,and the length of stay in EICU,and the correlation coefficient were-0.262,-0.697,-0.411,-0.444,-0.829 and-0.464(P<0.05),but serum 25(OH)D level had no correlation with GCS score,C-P,and total length of hospital stay(P>0.05).Compared with the survival group,ISS score,APACHEII score,FPG,Fins increased(P<0.05),and GCS score and 25(OH)D decreased in the death group(P<0.05),but the two groups had no significant differences in age,gender,or C-P(P>0.05).In multivariate logistic regression,the OR of 25(OH)D deficiency rate in the death group was 0.958(95%CI,0.818 ~ 1.121)compared with the survival group.Conclusion: The early serum 25(OH)D level was deficient in patients with severe multiple trauma,and was associated with the severity of severe multiple trauma,but may not be an independent risk factor for death in patients with severe multiple trauma.