Serum 25-hydroxyvitamin D predicts severity and prognosis in stroke patients
European Journal of Neurology,  Clinical Article

Daubail B et al. – A low serum 25(OH)D level is a predictor of both severity at admission and poor early functional outcome in stroke patients. The underlying mechanisms of these associations remain to be investigated.

Methods
  • From February 2010 to December 2010, consecutive stroke patients admitted to the department of neurology of Dijon, France, were identified.
  • Clinical information was collected.
  • Serum concentration of 25(OH)D was measured at baseline.
  • Stroke severity was assessed at admission using the NIHSS score.
  • Functional impairment was evaluated at discharge using the modified Rankin scale (m–Rankin).
  • Multivariate analyses were performed using logistic regression models.

Results
  • Of the 386 recorded patients, serum 25(OH)D levels were obtained in 382 (median value=35.1 nM; IQR=21–57.8).
  • At admission, 208 patients had a NIHSS ≤5, with a higher mean 25(OH)D level than that observed in patients with moderate–to–high severity (45.9 vs. 38.6 nM, P<0.001).
  • In multivariate analyses, a 25(OH)D level in the lowest tertile (<25.7 nM) was a predictor of a NIHSS ≥6 (OR = 1.67; 95% CI = 1.05–2.68; P = 0.03).
  • The mean 25(OH)D level was lower in patients with moderate–to–severe handicap at discharge (m–Rankin 3–6) than in patients with no or mild handicap (35.0 vs. 47.5 nM, P<0.001).
  • In multivariate analyses, the lowest tertile of 25(OH)D level (<25.7 nM) was associated with a higher risk of moderate–to–severe handicap (OR = 2.06; 95% CI=1.06–3.94; P=0.03).

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