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 .
Calcitriol Deficiency and 1-Year Mortality in Cardiac Transplant Recipients
Background . Administration of the vitamin D hormone calcitriol improves survival in solid-organ transplanted experimental animals . We investigated whether lower serum calcitriol concentrations are associated with increased 1-year mortality in cardiac transplant recipients . Methods . We prospect ively recruited 171 patients who underwent cardiac transplantation at out institution between May 2004 and April 2006 . We assessed  calciotropic hormones , inflammation markers , and renal function preoperatively and on postoperative days 6 ( t1 ) and 21 ( t2 ) . Results . Serum creatinine and C-reactive protein increased , whereas calcitriol decreased significantly after transplantation ( P<0.001 ) . As determined by multivariable Cox regression analysis , the calcitriol level at t2 was an independent predictor of 1-year mortality . One-year mortality was 3.7 per 100 person-years in the tertile with the highest calcitriol concentrations at t2 ( > 18 pg/mL ) , 13.2 per 100 person-years in the intermediate tertile ( 11–18 pg/mL ) , and 32.1 per 100 person-years in the tertile with the lowest calcitriol concentrations at t2 ( < 11 pg/mL ) ( P<0.001 ) .  25-hydroxyvitamin D deficiency ( serum concentrations below 10 ng/mL ) , renal insufficiency ( serum creatinine ≥1.6 mg/dL ) , and high serum concentrations of the inflammation markers C-reactive peptide and tumor necrosis factor-&agr ; were predictors of a serum calcitriol concentration below 11 pg/mL ( P=0.037–0.001 ) . Conclusions . Low postoperative calcitriol concentrations are independently associated with high 1-year mortality in cardiac transplant recipients . A causal relationship has yet to be proven by intervention trials using active vitamin
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 .