Introduction: Low levels of vitamin D are associated with higher mortality in critically ill patients. Studies on vitamin D levels in adult burn patients and their influence on clinical outcomes are scarce. Therefore, vitamin D status following thermal injury is often overlooked as its clinical implications are poorly understood.
Aim: To examine the relationship of major thermal injury on the vitamin D axis and the influence of vitamin D levels on outcomes in adult burn patients.
Methods: An observational cohort study in major burn injury patients (TBSA ≥20%) with patients followed up for 1 year following injury and blood samples taken at 10 timepoints. Vitamin D metabolites and their serum carrier vitamin D binding protein (DBP) were assessed using LC-MS/MS and ELISA respectively. Various clinical outcomes of patients were recorded, including wound healing, sepsis, multiorgan failure, mortality.
Results: 38 burn patients with median TBSA of 42% were assessed. The inactive circulating form of vitamin D, 25-hydroxyvitamin D3 (25D3) and DBP were significantly reduced following major burn injury compared with healthy controls. Median 25D3 remained low.
Conclusion: Thermal injury affects vitamin D status, with low 25D3 levels predisposing patients to poorer prognosis. Data indicate that low serum 25D3 impairs tissue-specific antibacterial and wound healing responses in burn patients, potentially via tissue-specific activation and function. Supplementing with high doses of vitamin D to increase serum 25D3 may greatly improve health outcomes in burns patients.