Pre-Op Vitamin D and Infection Risk Following Gastric Bypass Surgery

Sadeq A. Quraishi, MD, MHA Massachusetts General Hospital, Harvard Medical School Boston, Interview with:
Sadeq A. Quraishi, MD, MHA
Massachusetts General Hospital, Harvard Medical School
Boston, Massachusetts What are the main findings of the study?

Dr. Quraishi: Our retrospective study suggests that there is an association between pre-operative 25-hydroxyvitamin D [25(OH)D] levels and the risk of hospital-acquired infections after gastric bypass surgery. In particular, patients with 25(OH)D levels <30 ng/ml before surgery were almost 4 times more likely to develop a surgical site infection within 30 days of surgery than patients with pre-operative 25(OH)D levels at 30 ng/ml or higher. Were any of the findings unexpected?

Dr. Quraishi: While the findings themselves are not surprising, given our emerging understanding of how vitamin D status affects immune function, the magnitude of this association is rather surprising. We did select a patient cohort at high risk for low 25(OH)D levels and high risk for hospital-acquired infections. As such, further studies are needed to extend our work, to assess the generalizability of our findings to all surgical patients, and to test whether vitamin D supplementation can influence the risk of developing hospital-acquired infections. What should clinicians and patients take away from your report?

Dr. Quraishi: We believe that 25(OH)D optimization before surgery is a promising strategy for supporting immune health through the perioperative setting. Active research in this area by our group and others will help us to better understand whether vitamin D supplementation is indeed helpful, and if so, how much to take and when to take it. What recommendations do you have for future research as a result of this study?

Dr. Quraishi:  Observational research (such as this study) helps us to generate more questions and provides a rationale to further pursue an idea – it does not address the issue of causality. To answer the question of whether vitamin D supplementation can reduce the risk of hospital-acquired infections, well-designed, placebo-controlled clinical trials are the next step.


Association Between Preoperative 25-Hydroxyvitamin D Level and Hospital-Acquired Infections Following Roux-en-Y Gastric Bypass Surgery.

Quraishi SA, Bittner EA, Blum L, Hutter MM, Camargo CA Jr.
JAMA Surg. 2013 Nov 27. doi: 10.1001/jamasurg.2013.3176. [Epub ahead of print]