Vitamin K deficiency in critical ill patients; a prospective observational study

Research output: Contribution to journalArticle

Standard

Vitamin K deficiency in critical ill patients; a prospective observational study. / Dahlberg, Sofia; Schurgers, Leon; Schött, Ulf; Kander, Thomas.

In: Journal of Critical Care, Vol. 49, 0883-9441, 2019, p. 105-109.

Research output: Contribution to journalArticle

Harvard

APA

CBE

MLA

Vancouver

Author

RIS

TY - JOUR

T1 - Vitamin K deficiency in critical ill patients; a prospective observational study

AU - Dahlberg, Sofia

AU - Schurgers, Leon

AU - Schött, Ulf

AU - Kander, Thomas

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2019

Y1 - 2019

N2 - Background: Vitamin K is a cofactor for proteins involved in cardiovascular health, bone metabolism and cancer. Measuring uncarboxylated prothrombin, also termed as “protein induced by vitamin K absence or antagonism for factor II (PIVKA-II)”, has been used to assess vitamin K status. High levels may indicate vitamin K deficiency. The aim of this study was to measure PIVKA-II and prothrombin time (PT-INR) in intensive care (ICU) patients and correlate vitamin K status with mortality. Methods: Ninety-five patients admitted to the ICU had blood samples taken near admission and every third day. In addition to PIVKA-II and PT-INR, critical-care severity scores were computed. Results: The median baseline PIVKA-II was 4.97 μg/L compared to the upper reference of 2.0 μg/L. PIVKA-II further increased at days 3 and 6, (median 7.88 μg/L, p = .047 and median 8.14 μg/L, p = .011) predominantly in cardiac arrest patients (median 21.4 μg/L, day 3). Conclusion: Intensive care patients have increased PIVKA-II levels at admission, which increases during the ICU stay, especially in cardiac arrest patients. There were no correlations between PIVKA-II and PT-INR, SOFA score or mortality. Further studies are needed to determine why PIVKA-II increases and whether high PIVKA-II levels in ICU patients affect long-term mortality or morbidity. Previous article in issue

AB - Background: Vitamin K is a cofactor for proteins involved in cardiovascular health, bone metabolism and cancer. Measuring uncarboxylated prothrombin, also termed as “protein induced by vitamin K absence or antagonism for factor II (PIVKA-II)”, has been used to assess vitamin K status. High levels may indicate vitamin K deficiency. The aim of this study was to measure PIVKA-II and prothrombin time (PT-INR) in intensive care (ICU) patients and correlate vitamin K status with mortality. Methods: Ninety-five patients admitted to the ICU had blood samples taken near admission and every third day. In addition to PIVKA-II and PT-INR, critical-care severity scores were computed. Results: The median baseline PIVKA-II was 4.97 μg/L compared to the upper reference of 2.0 μg/L. PIVKA-II further increased at days 3 and 6, (median 7.88 μg/L, p = .047 and median 8.14 μg/L, p = .011) predominantly in cardiac arrest patients (median 21.4 μg/L, day 3). Conclusion: Intensive care patients have increased PIVKA-II levels at admission, which increases during the ICU stay, especially in cardiac arrest patients. There were no correlations between PIVKA-II and PT-INR, SOFA score or mortality. Further studies are needed to determine why PIVKA-II increases and whether high PIVKA-II levels in ICU patients affect long-term mortality or morbidity. Previous article in issue

U2 - 10.1016/j.jcrc.2018.10.022

DO - 10.1016/j.jcrc.2018.10.022

M3 - Article

VL - 49

SP - 105

EP - 109

JO - Journal of Critical Care

T2 - Journal of Critical Care

JF - Journal of Critical Care

SN - 1557-8615

M1 - 0883-9441

ER -