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Tennessee Medicine E-Journal

Abstract

Aim: The increase in the geriatric population will increase use of long-term care facilities. Few studies have addressed contributory factors to outcomes in long-term care in veterans. Many abnormal biochemical parameters including vitamin D deficiency could contribute to adverse outcomes. The present study was undertaken to determine if vitamin D status was superior to serum albumin in predicting length of stay and mortality among veterans in long-term care facilities.

Methods: Data were collected via retrospective chart review at six Veterans Administration Medical Centers in the Southeast United States on patients admitted to long-term care facilities.

Results: In the study group (n=131), vitamin D status did not predict length of stay in the facility. However, serum albumin was the strongest predictor of mortality at one month and one year. Serum creatinine and alkaline phosphatase provided a secondary contribution to one-month mortality, and serum triglycerides accounted for additional variance in one-year mortality.

Conclusions: Clinicians should be aware that serum albumin level is superior to vitamin D status in predicting adverse outcomes in long-term care. This contrasts with prior reports indicating that vitamin D was a significant predictor of mortality in admissions to intensive care unit. However, given the multiple complex factors that interact and evolve to determine length of stay and mortality, additional study of this apparent paradox is warranted. While vitamin D was not predictive of either length of stay or mortality in this long-term care population, the other benefits of vitamin D replacement make a vitamin D-replete state desirable.

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