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 .
Association between preoperative 25-hydroxyvitamin D level and hospital-acquired infections following Roux-en-Y gastric bypass surgery.
IMPORTANCE Postoperative hospital-acquired infections ( HAIs ) may result from disruption of natural barrier sites . Recent studies have linked vitamin D status and barrier site integrity . OBJECTIVE To investigate the association between preoperative vitamin D status and the risk for HAIs . DESIGN , SETTING , AND PARTICIPANTS A retrospective analysis was performed using propensity score methods to construct a matched-pairs cohort to reduce baseline differences between patients with 25-hydroxyvitamin D ( 25[OH]D ) levels less than 30 ng/mL vs 30 ng/mL or greater .  Multivariable logistic regression analysis was then performed to examine the association between 25(OH)D levels and HAIs while adjusting for additional perioperative factors . Locally weighted scatterplot smoothing was used to depict the relationship between increasing 25(OH)D levels and the risk for HAIs . This study was conducted in a single , teaching hospital in Boston , Massachusetts , and involved 770 gastric bypass surgery patients between January 1 , 2007 , and December 31 , 2011 . EXPOSURES Preoperative 25(OH)D levels . MAIN OUTCOMES AND MEASURES Association between preoperative 25(OH)D levels and the risk for postoperative HAIs . RESULTS The risk for HAIs was 3-fold greater ( adjusted odds ratio , 3.05 ; 95 % CI , 1.34 - 6.94 ) in patients with 25(OH)D levels less than 30 ng/mL vs 30 ng/mL or greater . Further adjustment for additional perioperative factors did not material ly change this association . Locally weighted scatterplot smoothing analysis depicted a near inverse linear relationship between vitamin D status and the risk for HAIs for 25(OH)D levels around 30 ng/mL. CONCLUSIONS AND RELEVANCE In our patient cohort , a significant inverse association was observed between preoperative 25(OH)D levels and the risk for HAIs . These results suggest that preoperative 25(OH)D levels may be a modifiable risk factor for postoperative nosocomial infections . Prospect i ve studies must determine whether there is a potential benefit to preoperative optimization of vitamin D status
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 .