Abstract
Objectives
Severe 25-hydroxyvitamin D (25(OH)D) deficiency can result in life-threatening presentations due to hypocalcemia leading to seizures and cardiac arrhythmias. vitamin D deficiency is a common cause of hypocalcemia and rickets in children; however, there are no recent studies on the burden of inpatient admissions in the United States. Our study aims to describe the clinical characteristics and risk factors of inpatient admissions due to severe hypocalcemia and 25(OH)D deficiency at a freestanding academic children’s hospital.
Methods
A descriptive retrospective chart review was completed on all inpatient admissions from 2016 to 2021 for children 0–18 years of age with corrected calcium <8 mg/dL and 25(OH)D <10 ng/mL during admission.
Results
Thirty-eight patients met the inclusion criteria (74 % Black/African American). Neurological signs described in 49 %, bone abnormalities in 17 % and EKG abnormalities in 42 % of the patients. The mean calcium serum level was 6.0 mmol/L (range 5.0–7.9 mmol/L), the mean iCa 0.77 mmol/L (range 0.54–0.99 mmol/L). The mean level of 25(OH)D was 5.5 ng/mL (range 2.1–9.7 ng/mL). The median length of stay was 4.5 (range 1–59 days).
Conclusions
In this retrospective observational study, risk factors identified: (1) Black/African American race (2) age less than two years (3) lack of supplementation of vitamin D and (4) dietary restrictions. Inpatient admissions are preventable through the implementation of education at the community and healthcare levels.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Nadia Merchant has no conflict of interest with this topic, she is on advisory board of Pfizer and BioMarin. The other authors state no conflict of interest.
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Informed consent: The study was approved by the hospitals institutional review board at Children’s National Hospital in Washington, DC and exempted from requiring written informed consent.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
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