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Nutrients 2017, 9(1), 1; doi:10.3390/nu9010001

Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk

1
Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
2
Experimental and Forensic Medicine, Department of Public Health, University of Pavia, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
3
Biometry and Clinical Epidemiology Service, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
4
Laboratory Analysis Service, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
*
Author to whom correspondence should be addressed.
Received: 27 October 2016 / Revised: 12 December 2016 / Accepted: 19 December 2016 / Published: 23 December 2016
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Abstract

Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients at nutritional risk has not been assessed. Methods: In this five-year prospective study, we investigated whether high vitamin B12 concentrations (>1000 pg/mL) are associated with in-hospital mortality in 1373 not-bed-ridden adult patients at nutritional risk (Nutrition Risk Index <97.5), admitted to medical and surgical departments. Results: Three hundred and ninety-six (28.8%) patients presented vitamin B12 > 1000 pg/mL. Two hundred and four patients died in the hospital (14.9%). The adjusted odds ratio of in-hospital mortality in patients with high vitamin B12 was 2.20 (95% CI, 1.56–3.08; p < 0.001); it was independent of age, gender, body mass index, six-month previous unintentional weight loss, admission ward, presence of malignancy, renal function, C-reactive protein and prealbumin. Patients with high vitamin B12 also had a longer length of stay (LOS) than those with normal concentrations (median 25 days, (IQR 15–41) versus 23 days (IQR 14–36); p = 0.014), and elevated vitamin B12 was an independent predictor of LOS (p = 0.027). Conclusions: An independent association between elevated vitamin B12 concentrations, mortality and LOS was found in our sample of hospitalized adult patients at nutritional risk. Although the underlying mechanisms are still unknown and any cause-effect relation cannot be inferred, clinicians should be aware of the potential negative impact of high vitamin B12 concentrations in hospitalized patients at nutritional risk and avoid inappropriate vitamin supplementation. View Full-Text
Keywords: vitamin B12; in-hospital mortality; length of stay; nutritional risk vitamin B12; in-hospital mortality; length of stay; nutritional risk
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Cappello, S.; Cereda, E.; Rondanelli, M.; Klersy, C.; Cameletti, B.; Albertini, R.; Magno, D.; Caraccia, M.; Turri, A.; Caccialanza, R. Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk. Nutrients 2017, 9, 1.

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