Evaluation of Serum Vitamin D Levels and its Association with Increased Risk of Pressure Ulcer among Non-Ambulatory Patients

Main Article Content

Usama Shabir Khan
Aneela Amjad
Muhammad Usman Naeem
Faseeha Saleem
Arslan Ali
Aneela Safdar

Abstract

Background: Pressure ulcers are a significant health concern for non-ambulatory patients, often resulting from prolonged immobility. Vitamin D, recognized for its role in skin health and wound healing, may influence the development of these ulcers. This study examines the relationship between serum vitamin D levels and the prevalence of pressure ulcers in individuals unable to walk or move independently.


Objective: To explore the association between serum Vitamin D levels and the risk of pressure ulcers, aiming to contribute to the literature and improve patient outcomes through evidence-based healthcare practices.


Methods: A cross-sectional study was conducted at Sheikh Zayed Hospital and Bahria International Hospital, Lahore, from August 2023 to January 2024. Seventy non-ambulatory patients were recruited using a non-probability convenient sampling method. The Braden scale was employed to assess pressure ulcer severity, and serum vitamin D levels were measured through blood samples.


Results: Participants had a mean age of 38.5 years (SD = 6.27) and a mean non-ambulatory duration of 13.72 days (SD = 5.22). Gender distribution was 55.7% female and 44.3% male. Historical pressure ulcer incidence was 10%. The leading reasons for hospitalization were stroke (28.6%), neuromuscular conditions (31.4%), and road traffic accidents (38.6%). A significant positive correlation was found between Braden scale scores and vitamin D levels (11.91 ± 3.40 and 11.40 ± 3.40 respectively, Pearson correlation coefficient = 0.71, p < 0.01).


Conclusion: There is a significant association between low serum vitamin D levels and an increased risk of developing pressure ulcers in non-ambulatory patients, supporting the need for vigilant monitoring and management of vitamin D levels.

Article Details

How to Cite
Khan, U. S., Amjad, A., Naeem, M. U., Saleem, F., Ali, A., & Safdar, A. (2024). Evaluation of Serum Vitamin D Levels and its Association with Increased Risk of Pressure Ulcer among Non-Ambulatory Patients. Journal of Health and Rehabilitation Research, 4(2), 922–926. https://doi.org/10.61919/jhrr.v4i2.948
Section
Articles
Author Biographies

Usama Shabir Khan, Pakistan Society for the Rehabilitation of the Disabled Lahore Pakistan.

Pakistan Society for the Rehabilitation of the Disabled Lahore, Pakistan.

Aneela Amjad, Pakistan Society for the Rehabilitation of the Disabled Lahore Pakistan.

Lecturer of Physiology, Pakistan Society for the Rehabilitation of the Disabled Lahore, Pakistan.

Muhammad Usman Naeem, Sheikh Zayed Hospital Lahore Pakistan

Senior Registrar Sheikh Zayed Hospital Lahore, Pakistan.

Faseeha Saleem, Pakistan Society for the Rehabilitation of the Disabled Lahore Pakistan.

Demonstrator, Basic Health Sciences, Pakistan Society for the Rehabilitation of the Disabled Lahore, Pakistan.

Arslan Ali, Lahore General Hospital Lahore Pakistan.

Resident Surgeon, Lahore General Hospital Lahore, Pakistan.

Aneela Safdar, Fatima Memorial Hospital Lahore Pakistan.

Post-graduation Training in Gynaecology FCPS, Fatima Memorial Hospital Lahore, Pakistan.

References

Kottner J, Cuddigan J, Carville K, Balzer K, Berlowitz D, Law S, et al. Pressure ulcer/injury classification today: An international perspective. Journal of Tissue Viability. 2020;29(3):197-203.

Stefanopoulos S, Qiu Q, Alshaibani K, Bauer K, Ahmed A, Nazzal M, et al. Evaluation of current pressure ulcer staging. The American Surgeon™. 2023;89(4):665-70.

Gefen A, Brienza DM, Cuddigan J, Haesler E, Kottner J. Our contemporary understanding of the aetiology of pressure ulcers/pressure injuries. International wound journal. 2022;19(3):692-704.

Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC geriatrics. 2018;18(1):1-11.

Navarro-Triviño F, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the skin: A review for dermatologists. Actas Dermo-Sifiliográficas (English Edition). 2019;110(4):262-72.

Reichrath J, Bischoff-Ferrari HA. Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes. Sunlight, Vitamin D and Skin Cancer. 2014:500-25.

Saghaleini SH, Dehghan K, Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z. Pressure ulcer and nutrition. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2018;22(4):283.

Bocheva G, Slominski RM, Slominski AT. The impact of vitamin D on skin aging. International Journal of Molecular Sciences. 2021;22(16):9097.

Razzaghi R, Pourbagheri H, Momen-Heravi M, Bahmani F, Shadi J, Soleimani Z, et al. The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: a randomized, double-blind, placebo-controlled trial. Journal of Diabetes and its Complications. 2017;31(4):766-72.

Smith K, Hewlings S. Correlation between vitamin D levels and hard-to-heal wounds: a systematic review. Journal of wound care. 2021;30(Sup6):S4-S10.

Otero TM, Canales C, Yeh DD, Elsayes A, Belcher DM, Quraishi SA. Vitamin D status is associated with development of hospital‐acquired pressure injuries in critically ill surgical patients. Nutrition in Clinical Practice. 2019;34(1):142-7.

Nadukkandiyil N, Syamala S, Saleh HA, Sathian B, Ahmadi Zadeh K, Acharath Valappil S, et al. Implementation of pressure ulcer prevention and management in elderly patients: a retrospective study in tertiary care hospital in Qatar. The Aging Male. 2020;23(5):1066-72.

Shen L, Ji HF. Vitamin D deficiency is associated with increased risk of Alzheimer's disease and dementia: evidence from meta-analysis. Nutr J. 2015;14:76.

Kalava UR, Cha SS, Takahashi PY. Association between vitamin D and pressure ulcers in older ambulatory adults: results of a matched case-control study. Clin Interv Aging. 2011;6:213-9.

Reza R, Hamideh P, Mansooreh M-H, Fereshteh B, Jafar S, Zahra S, et al. The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial. Journal of Diabetes and its Complications. 2017;31(4):766-72.

Mirghani HO. Vitamin D deficiency among outpatients and hospitalized patients with diabetic foot ulcers: A systematic review and meta-analysis. World Journal of Meta-Analysis. 2023;11(5):218-27.

Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117(4):503-11.

Priyanto MH, Legiawati L, Saldi SRF, Yunir E, Miranda E. Comparison of vitamin D levels in diabetes mellitus patients with and without diabetic foot ulcers: An analytical observational study in Jakarta, Indonesia. International Wound Journal. 2023.

Kalava U, Cha S, Takahashi P. Association between vitamin D and pressure ulcers in older ambulatory adults: Results of a matched case-control study. Clinical interventions in aging. 2011;6:213- 9.

Ateeq I, Baby T, Amer I, Chehab F, Salim NA. Associated Risk Factors and Barriers of Pressure Injury Wound Healing Process: A Retrospective Study of Single-Center Experience. Dubai Medical Journal. 2022;5(3):163-70.

Mehboobali N, Iqbal SP, Iqbal MP. High prevalence of vitamin D deficiency and insufficiency in a low income peri-urban community in Karachi. Journal of Pakistan Medical Association. 2015;65(9):946.

Buh AW, Mahmoud H, Chen W, McInnes MDF, Fergusson DA. Effects of implementing Pressure Ulcer Prevention Practice Guidelines (PUPPG) in the prevention of pressure ulcers among hospitalised elderly patients: a systematic review protocol. BMJ Open. 2021;11(3):e043042.

Cereda E, Neyens JCL, Caccialanza R, Rondanelli M, Schols JMGA. Efficacy of a disease-specific nutritional support for pressure ulcer healing: A systematic review and meta-analysis. The journal of nutrition, health & aging. 2017;21(6):655-61.

Manley S, Mitchell A. The impact of nutrition on pressure ulcer healing. British Journal of Nursing. 2022;31(12):S26-S30.

Most read articles by the same author(s)