In conclusion , this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures .
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 Association of Serum Vitamin D Concentration with Serious Complications After Noncardiac Surgery
BACKGROUND : Vitamin D deficiency is a global health problem . Epidemiological studies demonstrate that vitamin D is both cardioprotective and neuroprotective . Vitamin D also plays a substantial role in innate and acquired immunity . Our goal was to evaluate the association of serum vitamin D concentration on serious postoperative complications and death in noncardiac surgical patients . METHODS : We retrospectively analyzed the data of 3509 patients who had noncardiac surgery at the Clevel and Clinic Main Campus and had a serum vitamin D measurement . The relationship between serum vitamin D concentration and all-cause in-hospital mortality , in-hospital cardiovascular morbidity , and serious in-hospital infections was assessed as a common effect odds ratio ( OR ) by using a multivariate generalized estimating equation model with adjustment for demographic , medical history variables , and type and duration of surgery . RESULTS : Higher vitamin D concentrations were associated with decreased odds of in-hospital mortality/morbidity ( P = 0.003 ) . There was a linear reduction of the corresponding common effect odds ratio ( OR 0.93 , 95 % confidence interval , 0.88–0.97 ) for severe in-hospital outcomes for each 5 ng/mL increase in vitamin D concentration over the range from 4 to 44 ng/mL. In addition , we found that the odds versus patients  with vitamin D < 13 ng/mL ( i.e. , 1st quintile ) were significantly lower in patients with vitamin D 13–20 , 20–27 , 27–36 , and > 36 ng/mL ( i.e. , 2nd–5th quintiles ) ; the corresponding estimated ORs were 0.65 ( 99 % confidence interval , 0.43–0.98 ) , 0.53 ( 0.35–0.80 ) , 0.44 ( 0.28–0.70 ) , and 0.49 ( 0.31–0.78 ) , respectively . However , there was no statistically significant difference among individual quintiles > 13 ng/mL. CONCLUSIONS : Vitamin D concentrations were associated with a composite of in-hospital death , serious infections , and serious cardiovascular events in patients recovering from noncardiac surgery . While causality can not be determined from our retrospective analysis , the association suggests that a large r and omized trial of preoperative vitamin D supplementation and postoperative outcomes is warranted
In conclusion , this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures .
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 .