Vitamin D supplementation is associated with improved outcomes in critically ill patients with acute pancreatitis in the intensive care unit: a retrospective analysis based on the MIMIC-IV database

Vitamin D supplementation is associated with improved outcomes in critically ill patients with acute pancreatitis in the intensive care unit: a retrospective analysis based on the MIMIC-IV database | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Vitamin D supplementation is associated with improved outcomes in critically ill patients with acute pancreatitis in the intensive care unit: a retrospective analysis based on the MIMIC-IV database Fei Zhang, Weijuan Hu, Yonghao Ouyang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8300548/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background Acute pancreatitis (AP) is a common gastrointestinal emergency, and its progression to severe forms in the intensive care unit (ICU) is associated with high mortality. Vitamin D, beyond its classical role in bone metabolism, possesses significant immunomodulatory and anti-inflammatory properties. Although numerous studies have found that vitamin D supplementation may improve prognoses in critically ill patients, no research to date has demonstrated a benefit in patients with AP. Therefore, this study examined the association between vitamin D supplementation and mortality in ICU patients with AP. Methods This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Adult ICU patients diagnosed with AP were included. Patients were categorized into vitamin D and non-vitamin D groups based on supplementation during their ICU stay. The primary and secondary outcomes were 28-day and 90-day all-cause mortality, respectively. Associations were assessed using Kaplan-Meier (KM) survival curves and multivariable Cox proportional-hazards models, with adjustments for relevant demographic, clinical, and laboratory confounders. Results The study finally included 1068 patients with AP, comprising 131 and 937 in the vitamin D and non-vitamin D groups, respectively. The KM survival curves indicated that the survival probability differed significantly between the two groups. Following multivariate COX regression, which was adjusted for confounding factors, the hazard ratio (95% confidence interval) values for 28-day and 90-day mortality in the vitamin D group were 0.29 (0.15, 0.55) and 0.33 (0.2, 0.54), respectively. Conclusion In this retrospective analysis, vitamin D supplementation was independently associated with a significant reduction in 28-day and 90-day mortality among ICU patients with AP. Given the favourable safety profile and low cost of vitamin D, these findings warrant confirmation in large-scale, prospective randomised controlled trials to establish a potential causal relationship and guide clinical practice. Vitamin D Acute pancreatitis Mortality MIMIV-IV database Figures Figure 1 Figure 2 Figure 3 Introduction Acute pancreatitis (AP) is a prevalent gastrointestinal disorder triggered by various causes that induce the aberrant activation of pancreatic enzymes, leading to pancreatic and peri-pancreatic tissue damage and necrosis[ 1 – 3 ]. The principal causes are gallstones, alcohol and hypertriglyceridaemia[ 4 ]. Most patients present with mild symptoms, such as abdominal pain, bloating, nausea and vomiting, and the condition usually resolves spontaneously[ 5 , 6 ]. However, about 20% of patients progress to moderate or severe acute pancreatitis, which may produce pancreatic or peripancreatic necrosis, provoke a systemic inflammatory response syndrome and even cause multiple organ failure, with mortality as high as 30%[ 5 ]. Early assessment of disease severity and prompt, effective treatment are therefore of great clinical importance to improve survival. Vitamin D is an important fat-soluble vitamin in humans. It is synthesized in the skin and undergoes two hydroxylations in the liver and kidneys to produce the active form 1,25-dihydroxyvitamin D (1,25-(OH) 2 D)[ 7 – 9 ]. 1,25-(OH)₂D binds to the vitamin D receptor (VDR) in cells and mediates complex biological functions by regulating the transcription and expression of target genes[ 10 , 11 ]. Not only does vitamin D play a crucial role in bone metabolism, it also plays a key role in the immune system[ 12 , 13 ]. Immune cells, including activated T and B lymphocytes, neutrophils, and antigen-presenting cells, have been observed to express hydroxylase and the VDR[ 7 , 14 , 15 ]. A plethora of studies have demonstrated a correlation between vitamin D deficiency and an elevated risk and severity of a multitude of diseases, including infections, autoimmune diseases, cardiovascular diseases, tumours, sarcopenia, osteoarthritis, and transplant rejection[ 16 – 18 ]. There is currently no study or evidence to show whether vitamin D supplementation can improve the prognosis of patients with AP. Therefore, the objective of this study is to investigate the possible therapeutic benefits of vitamin D on the clinical outcomes of patients with AP, drawing upon the MIMIC Ⅳ database. This will provide more evidence for the clinical use of vitamin D and thus help improve prognosis. Method Data sources The data for this study were obtained from the the Medical Information Mart for Intensive Care IV ver 3.1 (MIMIC-IV, version 3.1) database, a large, publicly available resource developed by the Massachusetts Institute of Technology’s Laboratory of Computational Physiology. ( https://physionet.org/content/mimiciv/3.1/ )[ 19 ]. The database comprises records of patients with AP admitted to Beth Israel Deaconess Medical Center (BIDMC) from 2008 to 2022, and includes demographics, length of hospital stay, laboratory tests, medication treatment, vital signs and related information. To protect patients' privacy, all patients' personal information in this database had been de-identified, therefore, this study did not require patients' informed consent or ethical approval. The first author of this study, Fei Zhang, obtained access to the MIMIC-IV database by completing the Collaborative Institutional Training Initiative (CITI) programme (citiprogram.org) in accordance with relevant guidelines and regulations, and by passing the "Conflict of Interest" and "Data or Specimens Only Research" examinations (ZF, certification number 69083165). Population selection criteria The MIMIC-IV database contained a total of 546,028 hospitalization records, among which 94,458 were admitted to the ICU. Patients diagnosed with AP were identified using the International Classification of Diseases, Ninth Revision (ICD-9) code 577.0 and Tenth Revision (ICD-10) codes K85-K85.92, resulting in the inclusion of 7312 patients. Among these, 1,280 were admitted to the ICU. Further screening excluded patients meeting the following criteria: (1) age under 18 years at first admission; (2) repeated admissions for acute pancreatitis, retaining only the first admission data; (3) ICU stay duration less than 24 hours. Ultimately, 1068 patients were included in this study (Fig. 1 ). Data extraction The MIMIC-IV version 3.1 database recorded demographic variables such as patient age, sex, and race. Documented vital signs included heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), respiratory rate (RR), saturation of peripheral oxygen (SpO2), and body temperature. Recorded clinical interventions comprised statins, octreotide, vasopressin, β-blockers, mechanical ventilation, continuous renal replacement therapy (CRRT), and endoscopic retrograde cholangiopancreatography (ERCP). Admission complications were also annotated, including acute kidney injury (AKI), sepsis, respiratory failure (RF), heart failure (HF), atrial fibrillation (AF), hypertension, diabetes (DM), and obesity. Laboratory measurements included haematocrit (HCT), haemoglobin (HB), platelet count (PLT), red cell distribution width (RDW), red blood cell count (RBC), white blood cell count (WBC), albumin (ALB), anion gap, serum potassium, serum sodium, serum calcium, lactate (Lac), international normalised ratio (INR), prothrombin time (PT), glucose (GLU), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), creatinine (Cr), and blood urea nitrogen. All values correspond to the first test results performed after ICU admission with the initial 24h. Data were extracted by executing structured query language (SQL) and Navicat Premium software (Version 16). Outcomes The primary outcome was 28-day all-cause mortality, and the secondary outcomes included 90-day all-cause mortality. Statistical analysis Variables with less than 20% missing data, were handled by single imputation methods. Normally distributed continuous variables are expressed as mean ± standard deviation, and groups were compared using independent samples t-test. Non-normally distributed continuous variables are presented as median (interquartile range), and intergroup comparisons were performed with the Mann-Whitney U test. Categorical variables are reported as frequency and percentage, and group differences were assessed with the χ2 test. The KM curve and the log-rank test were used to evaluate whether vitamin D supplementation improved prognosis in patients with AP. We then fitted two COX proportional hazards models to examine the effect of vitamin D on outcomes. Model I adjusted for patient age, sex, SpO 2 , HF, RF, vasopressin, RDW, PT, and Cr to account for their potential influence on outcomes. Subgroup analyses were performed to assess the robustness of the association between vitamin D and outcomes across age, sex, HF, RF, and vasporession use. Data analysis in this study was performed using Free statistics software version 2.1. A two-sided value of P < 0.05 was considered to indicate statistical significance. Results Baseline demographic and clinical characteristics A total of 1,280 patients with AP admitted to the ICU were included in the analysis. Of these, 131 patients received vitamin D treatment, and 937 patients did not. The mean age of the cohort was 58.7 ± 17.3 years, with males accounting for 57.5% of the participants. Baseline patient characteristics are presented in Table 1. Patients in the non-vitamin D group were more likely to have hypertension but less likely to have HF and AKI. This group also had higher HCT, HB, RBC, and sodium and lower RDW, calcium, INR and PT than the vitamin D group. Statins and vasopressors were more frequently used in the vitamin D group, while the remaining covariates did not differ significantly between groups. Table 1. Baseline patient characteristics in patients with acute pancreatitis. Variables Total (n = 1068) Non-vitaminD (n = 937) VitaminD (n = 131) P Age, years 58.7 ± 17.3 58.9 ± 17.3 57.5 ± 17.2 0.394 Sex, n (%) 0.012 Male 614 (57.5) 552 (58.9) 62 (47.3) Female 454 (42.5) 385 (41.1) 69 (52.7) Race, n (%) White 668 (62.5) 586 (62.5) 82 (62.6) 0.453 Black 109 (10.2) 91 (9.7) 18 (13.7) Other 130 (12.2) 117 (12.5) 13 (9.9) Unkown 161 (15.1) 143 (15.3) 18 (13.7) Vital signs HR, beats/minute 100.7 ± 21.7 100.8 ± 21.9 100.2 ± 20.4 0.749 SBP, mmHg 125.6 ± 25.7 126.3 ± 25.8 120.3 ± 24.5 0.012 DBP, mmHg 73.2 ± 19.6 73.7 ± 19.7 69.3 ± 18.3 0.016 MAP, mmHg 85.9 ± 19.9 86.4 ± 19.9 81.8 ± 19.5 0.014 RR, beats/minute 21.4 ± 6.7 21.3 ± 6.6 22.2 ± 7.3 0.15 SpO2, % 96.1 ± 4.1 96.0 ± 4.3 96.6 ± 3.0 0.128 Temperature, ℃ 36.9 ± 1.9 36.9 ± 2.0 36.8 ± 0.7 0.933 Laboratory Indicators HCT, % 33.4 ± 7.4 33.8 ± 7.3 31.1 ± 7.8 <0.001 HB, g/dL 11.0 ± 2.5 11.2 ± 2.5 10.2 ± 2.6 < 0.001 PLT, 10^ 9 /L 215.5 ± 136.0 215.9 ± 135.3 213.3 ± 141.1 0.839 RDW, % 15.4 ± 2.5 15.3 ± 2.4 16.4 ± 2.9 < 0.001 RBC, 10^ 12 /L 3.6 ± 0.9 3.7 ± 0.8 3.3 ± 0.9 < 0.001 WBC, 10^ 9 /L 14.3 ± 8.4 14.4 ± 8.3 14.0 ± 8.5 0.616 ALB, g/L 28.4 ± 6.3 28.4 ± 6.3 28.7 ± 6.6 0.582 Anion_gap, mEq/L 16.1 ± 5.6 16.1 ± 5.5 16.1 ± 5.8 0.942 Calcium, mEg/L 8.0 ± 1.2 8.0 ± 1.1 8.2 ± 1.5 0.045 Potassium, mEg/L 4.2 ± 0.9 4.2 ± 0.9 4.1 ± 0.7 0.234 Sodium, mEg/L 137.9 ± 6.0 138.1 ± 6.0 136.6 ± 6.4 0.006 Lac, mmol/L 1.8 (1.3, 2.9) 1.8 (1.3, 2.9) 1.8 (1.3, 2.9) 0.916 INR 1.6 ± 1.0 1.6 ± 1.0 1.8 ± 1.1 0.007 PT, sec 17.4 ± 10.6 17.1 ± 10.4 19.7 ± 11.6 0.009 GLU, mmol/L 7.0 (6.0, 10.0) 7.0 (6.0, 10.0) 7.0 (6.0, 9.0) 0.511 ALT, IU/L 45.5 (23.0, 129.0) 47.0 (24.0, 136.0) 40.0 (20.0, 97.0) 0.067 AST, IU/L 68.0 (32.2, 164.8) 67.0 (32.0, 166.8) 73.0 (34.2, 142.0) 0.93 TBIL, μmol/L 17.1 (8.6, 47.9) 17.1 (8.6, 46.2) 20.5 (10.3, 59.9) 0.108 Cre, μmol/L 97.2 (61.9, 168.0) 97.2 (61.9, 168.0) 97.2 (61.9, 194.5) 0.937 Urea_nitrogen, mg/dL 20.0 (12.0, 37.0) 20.0 (12.0, 36.8) 23.0 (12.0, 40.0) 0.543 Comorbidity Sepsis3, n (%) 720 (67.4) 631 (67.3) 89 (67.9) 0.891 AKI, n (%) 721 (67.5) 619 (66.1) 102 (77.9) 0.007 Hypertension, n (%) 464 (43.4) 419 (44.7) 45 (34.4) 0.025 DM, n (%) 311 (29.1) 273 (29.1) 38 (29) 0.976 HF, n (%) 197 (18.4) 163 (17.4) 34 (26) 0.018 Obesity, n (%) 146 (13.7) 122 (13) 24 (18.3) 0.098 AF, n (%) 224 (21.0) 196 (20.9) 28 (21.4) 0.904 RF, n (%) 444 (41.6) 398 (42.5) 46 (35.1) 0.109 Treatment Statin, n (%) 95 ( 8.9) 73 (7.8) 22 (16.8) < 0.001 Octreotide, n (%) 115 (10.8) 93 (9.9) 22 (16.8) 0.018 Vasopressin, n (%) 241 (22.6) 205 (21.9) 36 (27.5) 0.151 Betablockers, n (%) 545 (51.0) 479 (51.1) 66 (50.4) 0.874 Ventilation, n (%) 866 (81.1) 756 (80.7) 110 (84) 0.368 CRRT, n (%) 156 (14.6) 135 (14.4) 21 (16) 0.622 ERCP, n (%) 28 ( 2.6) 23 (2.5) 5 (3.8) 0.376 Clinical outcome 28-day mortality 136 (12.7) 123 (13.1) 13 (9.9) 0.303 90-day mortality 185 (17.3) 162 (17.3) 23 (17.6) 0.939 Abbreviation: HR, heart rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; RR, respiratory rate; Spo2, saturation of peripheral oxygen; HCT, haematocrit; HB, haemoglobin, PLT, platelet count, RDW, red cell distribution width; RBC, red blood cell count; WBC, white blood cell count; ALB, albumin; Lac, lactate; INR, international normalized ratio; PT, prothrombin time, GLU, glucose; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TBIL, total bilirubin; Cre, creatinine; AKI, acute kidney injury; DM, diabetes; HF, heart failure; AF, atrial fibrillation; RF, respiratory failure; CRRT, continuous renal replacement therapy; ERCP, endoscopic retrograde cholangiopancreatography. Univariate and multivariate COX regression models of vitamin D with mortality in patients with AP First, univariate Cox regression, identified variables significantly associated with 28-day and 90-day mortality ( P < 0.05, Table 2 ). We then performed collinearity analysis and retained variables with VIF < 5, as candidates for multivariable modelling. The multivariate Cox model was adjusted for clinically relevant factors and included variables that were significant in the univariate analysis and had VIF < 5 in the collinearity assessment. Table 2 Univariate analysis of risk factor associated with 28-day and 90-day mortality in patients with AP. Item 28-day Mortality 90-day Mortality HR (95%CI) P (Wald's test) P (LR-test) HR (95%CI) P (Wald's test) P (LR-test) Age 1.03 (1.02, 1.04) < 0.001 < 0.001 < 0.001 < 0.001 Sex Male Reference Reference Female 0.99 (0.7, 1.39) 0.947 0.947 0.661 0.662 Race White Reference 0.002 Reference 0.002 Black 0.45 (0.2, 1.03) 0.059 0.54 (0.29, 1) 0.05 Other 0.77 (0.43, 1.38) 0.376 0.53 (0.3, 0.92) 0.025 Unknown 1.71 (1.15, 2.53) 0.008 1.35 (0.95, 1.92) 0.089 HR 0.9925 (0.985, 1.0001) 0.054 0.052 0.9922 (0.9859, 0.9985) 0.015 0.014 SBP 0.98 (0.98, 0.99) < 0.001 < 0.001 0.99 (0.98, 1) < 0.001 < 0.001 DBP 0.98 (0.97, 0.99) < 0.001 < 0.001 0.99 (0.98, 0.99) < 0.001 < 0.001 MAP 0.98 (0.98, 0.99) < 0.001 < 0.001 0.99 (0.98, 0.99) < 0.001 < 0.001 RR 1.0083 (0.9846, 1.0327) 0.495 0.498 0.9973 (0.9767, 1.0184) 0.801 0.801 SpO2 0.96 (0.93, 0.98) 0.002 0.007 0.95 (0.93, 0.98) < 0.001 < 0.001 Temperature 0.92 (0.89, 0.95) < 0.001 0.001 0.92 (0.89, 0.95) < 0.001 < 0.001 HCT 0.9905 (0.9692, 1.0122) 0.388 0.385 0.99 (0.97, 1.01) 0.213 0.21 HB 0.95 (0.89, 1.02) 0.148 0.143 0.95 (0.89, 1) 0.052 0.049 PLT 0.9986 (0.9972, 1) 0.046 0.036 0.9988 (0.9977, 1) 0.047 0.039 RDW 1.14 (1.09, 1.19) < 0.001 < 0.001 1.14 (1.1, 1.18) < 0.001 < 0.001 RBC 0.84 (0.69, 1.02) 0.082 0.079 0.88 (0.74, 1.03) 0.114 0.11 WBC 1.03 (1.01, 1.04) < 0.001 0.001 1.03 (1.01, 1.04) < 0.001 < 0.001 ALB 0.97 (0.95, 1) 0.038 0.037 0.98 (0.95, 1) 0.051 0.05 Anion_gap 1.08 (1.05, 1.11) < 0.001 < 0.001 1.06 (1.03, 1.08) < 0.001 < 0.001 Calcium 1.04 (0.91, 1.19) 0.535 0.536 1.01 (0.91, 1.13) 0.795 0.795 Potassium 1.32 (1.12, 1.54) < 0.001 0.002 1.23 (1.07, 1.42) 0.005 0.007 Sodium 1.0046 (0.9781, 1.0318) 0.738 0.738 0.9983 (0.9763, 1.0209) 0.884 0.884 Lac 1.18 (1.14, 1.23) < 0.001 < 0.001 1.15 (1.11, 1.2) < 0.001 < 0.001 INR 1.19 (1.07, 1.32) 0.002 0.007 1.19 (1.08, 1.32) < 0.001 0.002 PT 1.02 (1.01, 1.03) 0.001 0.007 1.02 (1.01, 1.03) < 0.001 0.003 GLU 0.9974 (0.9692, 1.0264) 0.858 0.855 0.9901 (0.9629, 1.018) 0.483 0.458 ALT 1 (0.9998, 1.0002) 0.945 0.945 1 (0.9997, 1.0002) 0.723 0.711 AST 1.0001 (1, 1.0001) 0.094 0.143 1 (1, 1.0001) 0.284 0.326 TBIL 1.0028 (1.0019, 1.0036) < 0.001 < 0.001 1.0023 (1.0015, 1.0031) < 0.001 < 0.001 Cre 1.0018 (1.0011, 1.0025) < 0.001 < 0.001 1.0014 (1.0008, 1.0021) < 0.001 < 0.001 Urea_nitrogen 1.01 (1.01, 1.02) < 0.001 < 0.001 1.01 (1.01, 1.01) < 0.001 < 0.001 Sepsis3 2.14 (1.32, 3.48) 0.002 < 0.001 1.8 (1.21, 2.7) 0.004 0.002 AKI 4.32 (2.19, 8.51) < 0.001 < 0.001 2.99 (1.79, 5.01) < 0.001 < 0.001 Hypertension 0.75 (0.53, 1.08) 0.12 0.115 0.74 (0.54, 1.01) 0.054 0.05 DM 1.02 (0.7, 1.47) 0.935 0.935 1.02 (0.75, 1.41) 0.881 0.882 HF 1.65 (1.13, 2.4) 0.01 0.013 1.64 (1.17, 2.3) 0.004 0.006 Obesity 1.15 (0.73, 1.81) 0.555 0.561 1.11 (0.75, 1.66) 0.593 0.597 AF 1.54 (1.07, 2.21) 0.021 0.025 1.73 (1.27, 2.35) < 0.001 < 0.001 RF 1.86 (1.3, 2.67) < 0.001 < 0.001 1.7 (1.25, 2.32) < 0.001 < 0.001 Statin 0.64 (0.31, 1.3) 0.213 0.182 0.63 (0.35, 1.14) 0.125 0.101 Octreotide 1.6 (1.05, 2.43) 0.028 0.036 1.14 (0.78, 1.66) 0.494 0.499 Vasopressin 5.88 (4.04, 8.57) < 0.001 < 0.001 3.81 (2.79, 5.22) < 0.001 < 0.001 Betablockers 0.43 (0.31, 0.61) < 0.001 < 0.001 0.53 (0.4, 0.71) < 0.001 < 0.001 Ventilation 1.24 (0.71, 2.16) 0.449 0.436 1.19 (0.74, 1.92) 0.467 0.456 CRRT 3.58 (2.54, 5.03) < 0.001 < 0.001 2.64 (1.96, 3.56) < 0.001 < 0.001 ERCP 1.91 (0.84, 4.33) 0.121 0.159 1.56 (0.73, 3.32) 0.252 0.283 VitaminD 0.56 (0.32, 1) 0.048 0.033 0.62 (0.4, 0.96) 0.031 0.022 The 28-day mortality was lower in the vitamin D group than in the non-vitamin D group, with a hazard ratio of 0.56 (95% CI 0.32-1, P = 0.048). Similarly, the 90-day mortality was lower in the vitamin D group than in the non-vitamin D group, with a hazard ratio of 0.62 (95% CI 0.4–0.96, P = 0.031) (Table 3 ). Table 3 Multivariant Cox regression models of Vitamin D with mortality in patients with AP. Outcomes Unadjusted Model 1 HR (95%CI) P Value HR (95%CI) P Value 28-day Mortality Non-Vitamin D Reference Reference Vitamin D 0.56 (0.32 ~ 1) 0.048 0.29 (0.15 ~ 0.55) < 0.001 90-day Mortality Non-Vitamin D Reference Reference Vitamin D 0.62 (0.4 ~ 0.96) 0.031 0.33 (0.2 ~ 0.54) < 0.001 Model 1: Adjusted for age, gender, SpO2, HF, RF, vasopression, RDW, PT, TBIL, Cr. After adjusting for clinically relevant covariates, the association between vitamin administration and reduced mortality remained significant. The adjusted hazard ratio for 28-day mortality was 0.54 (95% CI 0.42–0.69, P < 0.001), and for 90-day mortality, it was 0.64 (95% CI 0.52–0.77, P < 0.001) ( Table 3 ). Kaplan-Meier curve analysis The KM survial curves demonstrated that vitamin D group had lower mortality at 28-day, and 90-day compared to the non-vitamin D group (Fig. 2 ). Subgroup analyses for the vitamin D on clinical outcomes in patients with AP When the subgroups were analyzed according to age, sex, hypertension, RF, and vasopressin, the forest plots showed no interaction between vitamin D and most of the subgroups. However, there was an interaction at 28-day and 90-day mortality in the hypertension subgroup. The results are shown in Fig. 3 . Discussion As one of the common diseases in the digestive system, the prognosis of patients with AP varies significantly depending on the severity of the disease 5 . Vitamin D has immunomodulatory and anti-inflammatory properties, which may improve the prognosis of AP 15,20 . To date, no consensus exists on whether vitamin D supplementation improves the prognosis of critically ill patients with AP. Consequently, we conducted a large retrospective cohort study using the MIMIC-IV v 3.1 database. Numerous studies have demonstrated a correlation between vitamin D and AP. Abou et al. found that patients with AP have significantly higher rates of vitamin D deficiency, osteoporosis, and fracture risk compared to the general population[ 21 ]. Besides studies by Huh et al., Bang et al., and Leerhøy et al. also reported a high prevalence of vitamin D deficiency among patients with AP[ 22 – 24 ]. Although numerous studies have demonstrated a correlation between AP and vitamin D, most of these findings indicate unidirectional causality between the two. Few researchers have investigated the prognostic relationship between vitamin D and AP. The Cox regression analysis in this study revealed that vitamin D supplementation serves as an independent protective factor against AP. Previous studies by Cates et al. and Kim et al. in animals revealed a positive correlation between decreased 25(OH)D levels and the mortality rate of AP[ 25 , 26 ]. This conclusion supports the results of this study. This finding was also corroborated in the study by Huh et al.[ 22 ]. Some studies indicate that hypercalcemia induced by vitamin D deficiency may also increase the risk of AP[ 27 , 28 ]. KM analysis revealed that patients with AP who received vitamin D supplementation had a lower risk of death compared to those who did not. Current research on the impact of vitamin D supplementation on the prognosis of acute pancreatitis remains limited. Previous study by Sharma et al. found that vitamin D supplementation can reduce the risk of AP multi-organ failure[ 29 ]. This conclusion supports the results of our study. However, the inclusion of only 87 patients may be subject to significant bias. The mechanism underlying the relationship between vitamin D and AP remains incompletely understood. Studies have shown a correlation between vitamin D deficiency and exacerbated of the inflammatory response in individuals with AP, leading to poorer clinical outcomes[ 22 , 30 – 32 ]. Cai et al. suggest that vitamin D's anti-inflammatory and anti-fibrotic effects may be crucial for maintaining pancreatic homeostasis[ 1 ]. Kwong et al. and Woods et al. found that vitamin D deficiency-mediated hypercalcemia caused by CYP24A1 mutations increases the risk of AP[ 33 , 34 ]. Furthermore, polymorphisms in the VDR gene may also influence the severity and prognosis of AP[ 35 , 36 ]. The potential mechanism may also involve the interaction between vitamin D and the renin-angiotensin system (RAS)[ 37 ]. To the best of our knowledge, this is the first large-scale clinical study to investigate the association between vitamin D supplementation and clinical outcomes in patients with AP admitted to the ICU. The strengths of our study are noteworthy. First, we utilized the comprehensive MIMIC-IV database, which provided a substantial sample size and enhanced the generalizability of our findings. Second, we employed rigorous statistical methodologies, including multivariate Cox proportional hazards models and KM survival analysis, to robustly establish the independent protective association of vitamin D. Finally, we performed subgroup analyses to assess the consistency of this association across different patient populations, thereby strengthening the reliability of our conclusions. However, several limitations inherent to our study design must be acknowledged. First and foremost, this was a retrospective observational study. Although we adjusted for numerous clinically relevant confounders, unmeasured or residual confounding factors (e.g., nutritional status, detailed etiology of AP, or other concomitant treatments) could still influence the observed associations. Second, our analysis was based on diagnostic codes (ICD-9 and ICD-10) for patient identification, which, while standard for database studies, may be subject to coding inaccuracies or variability. Third, and critically, our data lacked information on baseline serum 25-hydroxyvitamin D levels. Consequently, we could not determine if the observed benefit was due to the correction of a pre-existing deficiency or a pharmacological effect of supplementation. Furthermore, details regarding the specific dosage, formulation, duration, and timing of vitamin D administration were not available, limiting the clinical translatability of our findings. Future prospective, randomized controlled trials are essential to confirm these results, define the optimal therapeutic regimen (including target patient population based on vitamin D status, dosage, and timing), and elucidate the underlying biological mechanisms. Conclusion In conclusion, this study compared the prognosis of AP patients receiving vitamin D supplementation versus those not receiving it using the MIMIC-IV database, demonstrating that vitamin D significantly improves patient outcomes. This study provides a theoretical basis for vitamin D supplementation during antipsychotic treatment. However, large-scale, multicenter prospective studies are still needed to verify this. Abbreviations AP Acute pancreatitis ICU Intensive care unit MIMIC-IV Medical Information Mart for Intensive care IV Kaplan-Meier KM 1,25-dihydroxyvitamin D 1,25-(OH) 2 D Vitamin D receptor VDR HR Heart rate SBP Systolic blood pressure DBP Diastolic blood pressure MAP Mean arterial pressure RR Respiratory rate SpO2 Saturation of peripheral oxygen CRRT Continuous renal replacement therapy ERCP Endoscopic retrograde cholangiopancreatography AKI Acute kidney injury RF Respiratory failure HF Heart failure AF Atrial fibrillation DM Diabetes HCT Haematocrit HB Haemoglobin PLT Platelet count RDW Red cell distribution width RBC Red blood cells count WBC White blood cells count ALB Albumin Lac Lactate INR International normalized ratio PT Prothrombin time GLU Glucose ALT Alanine aminotransferase AST Aspartate aminotransferase TBIL Total bilirubin Cr Creatinine Declarations Acknowledgements We acknowledged the contributions of the MIMIC-IV (version 3.1) program registry for creating and updating the MIMIC-IV database. Author contributions Fei Zhang created the study protocol, performed the statistical analyses and wrote the first manuscript draft. Weijuan Hu assisted with the study design, performed date collection and revised the manuscript. Yonghao Ouyang critically revised the manuscript. All authors have read and approved the final manuscript. Funding None Data availability The datasets analysed during the current study are available in the MIMIC-IV repository, https://physionet.org/content/mimiciv/3.1/. Ethics approval and consent to participate To protect patients' privacy, all patients' personal information in this database had been de-identified, therefore, this study did not require patients' informed consent or ethical approval. Consent for publication Not applicable. Competing interests The authors declare no competing interests. References Cai F, Hu C, Chen CJ, Han YP, Lin ZQ, Deng LH, Xia Q. Vitamin D and Pancreatitis: A Narrative Review of Current Evidence. Nutrients. 2022;14(10):2113. Goyal H, Awad H, Hu ZD. Prognostic value of admission red blood cell distribution width in acute pancreatitis: a systematic review. Ann Transl Med. 2017;5(17):342. Mihoc T, Latcu SC, Secasan CC, Dema V, Cumpanas AA, Selaru M, Pirvu CA, Valceanu AP, Zara F, Dumitru CS, Novacescu D, Pantea S. Pancreatic Morphology, Immunology, and the Pathogenesis of Acute Pancreatitis. Biomedicines. 2024;12(11):2627. Szatmary P, Grammatikopoulos T, Cai W, Huang W, Mukherjee R, Halloran C, Beyer G, Sutton R. Acute Pancreatitis: Diagnosis and Treatment. Drugs. 2022;82(12):1251–76. Wang J, Li H, Luo H, Shi R, Chen S, Hu J, Luo H, Yang P, Cai X, Wang Y, Zeng X, Wang D. Association between serum creatinine to albumin ratio and short- and long-term all-cause mortality in patients with acute pancreatitis admitted to the intensive care unit: a retrospective analysis based on the MIMIC-IV database. Front Immunol. 2024;15:1373371. Lu J, Wang Z, Mei W, Peng K, Zhang L, Wang G, Xu K, Wang Z, Peng Y, Lu Z, Shi X, Lu G, Wen L, Cao F, Chinese Hypertriglyceridemia-Associated Pancreatitis Study Group (CHPSG). A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitis. BMC Gastroenterol. 2025;15(1):374. Daryabor G, Gholijani N, Kahmini FR. A review of the critical role of vitamin D axis on the immune system. Exp Mol Pathol. 2023; 132–3: 104866. Bikle DD, Vitamin D. Newer Concepts of Its Metabolism and Function at the Basic and Clinical Level. J Endocr Soc. 2020;4(2):bvz038. Capobianco E, McGaughey V, Seraphin G, Heckel J, Rieger S, Lisse TS. Vitamin D inhibits osteosarcoma by reprogramming nonsense-mediated RNA decay and SNAI2-mediated epithelial-to-mesenchymal transition. Front Oncol. 2023;13:1188641. Saponaro F, Saba A, Zucchi R. An Update on Vitamin D Metabolism. Int J Mol Sci. 2020;21(18):6573. Koivisto O, Hanel A, Carlberg C. Key Vitamin D Target Genes with Functions in the Immune System. Nutrients. 2020;12(4):1140. Delrue C, Speeckaert MM. Vitamin D and Vitamin D-Binding Protein in Health and Disease. Int J Mol Sci. 2023;24(5):4642. Sporek M, Dumnicka P, Maziarz B, Laskowska A, Kuśnierz-Cabala B. Vitamin D levels in early phase of acute pancreatitis - preliminary study. Folia Med Cracov. 2024;64(3):91–101. Martens PJ, Gysemans C, Verstuyf A, Mathieu AC. Vitamin D's Effect on Immune Function. Nutrients. 2020;12(5):1248. Delrue C, Speeckaert MM. Vitamin D and Vitamin D-Binding Protein in Health and Disease. Int J Mol Sci. 2023;24(5):4642. Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, Martucci G, Pilz S, Malle O. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020;74(11):1498–513. Fekete M, Lehoczki A, Szappanos Á, Zábó V, Kaposvári C, Horváth A, Farkas Á, Fazekas-Pongor V, Major D, Lipécz Á, Csípő T, Varga JT. Vitamin D and Colorectal Cancer Prevention: Immunological Mechanisms, Inflammatory Pathways, and Nutritional Implications. Nutrients. 2025; 17(8): 1351. Islam H, Hassaan SM, Islam R, Islam T, Zaidi F, Rehman HU, Haque MMU, Turabee Z, Asim M, Ahmad I, Naveed AK. Vitamin D's Role in Cardiovascular Diseases. Discov Med. 2024;36(189):1973–86. Johnson AEW, Bulgarelli L, Shen L, Gayles A, Shammout A, Horng S, Pollard TJ, Hao S, Moody B, Gow B, Lehman LH, Celi LA, Mark RG. MIMIC-IV, a freely accessible electronic health record dataset. Sci Data. 2023;10(1):1. Chang SW, Lee HC. Vitamin D and health - The missing vitamin in humans. Pediatr Neonatol. 2019;60(3):237–44. Abou Saleh M, Alkhayyat M, Mansoor E, Khoudari G, Simons-Linares CR, Vargo J, Chahal P, Stevens T. The Risk of Vitamin D Deficiency, Osteoporosis, and Fractures in Acute Pancreatitis. Pancreas. 2020;49(5):629–33. Huh JH, Kim JW, Lee KJ. Vitamin D deficiency predicts severe acute pancreatitis. United Eur Gastroenterol J. 2019;7(1):90–5. Bang UC, Brandt L, Benfield T, Jensen JE. Changes in 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D are associated with maturation of regulatory T lymphocytes in patients with chronic pancreatitis: a randomized controlled trial. Pancreas. 2012;41(8):1213–8. Leerhøy B, Shabanzadeh DM, Nordholm-Carstensen A, Novovic S, Hansen MB, Jørgensen LN. Pancreatic function following post-endoscopic retrograde cholangiopancreatography pancreatitis: A controlled cohort study with long-term follow-up. United Eur Gastroenterol J. 2018;6(4):586–94. Cates MC, Singh SM, Peick AL, Harvey MH, Reber HA. Acute hypercalcemia, pancreatic duct permeability, and pancreatitis in cats. Surgery. 1988;104(2):137–41. PMID: 2456625. Kim DI, Kim H, Son P, Kang JH, Kang BT, Yang MP. Serum 25-hydroxyvitamin D concentrations in dogs with suspected acute pancreatitis. J Vet Med Sci. 2017;79(8):1366–73. Tešić-Rajković S, Radovanović-Dinić B, Mitić B, Dinić-Radović V, Jovanović M. Hyperparathyroidism as a cause of recurrent acute pancreatitis: A case report. Vojnosanit Pregl. 2016;73(11):1064–7. Saif A. Primary hyperparathyroidism presenting with acute pancreatitis and asymptomatic bone involvement. Clin Cases Min Bone Metab. 2015;12(2):199–201. Sharma V, Sharma R, Rana SS, Chaudhary V, Bhasin DK. 537 Impact of Vitamin D Supplementation on the Course, Severity, Complications and Outcome of Patients of Acute Pancreatitis With Vitamin D Deficiency. Gastroenterology. 2014;146(5):S–95. Kolosovych I, Hanol I, Bystrytska M, Uzun H. Changes in vitamin D and calcium-phosphorus metabolism in patients with severe acute pancreatitis. Turk J Surg. 2022;38(4):327–33. Ocal S, Cerci K, Buldukoglu OC, Atar GE, Harmandar FA, Cekin AH. Effect of serum vitamin D levels on the severity of acute pancreatitis: A prospective study. Pancreatology. 2024;24(2):206–10. The IOM–Endocrine Society Controversy on Recommended Vitamin D Targets. In Support of the IOM Position. in Vitamin D. Academic; 2018. pp. 1065–89. Kwong WT, Fehmi SM. Hypercalcemic Pancreatitis Triggered by Pregnancy With a CYP24A1 Mutation. Pancreas. 2016;45(6):e31–2. Woods GN, Saitman A, Gao H, Clarke NJ, Fitzgerald RL, Chi NW. A Young Woman With Recurrent Gestational Hypercalcemia and Acute Pancreatitis Caused by CYP24A1 Deficiency. J Bone Min Res. 2016;31(10):1841–4. El-Mahdy RI, Ramadan HK, Mohammed HSED, Ahmed EH, Mokhtar AA, Hosni A. Impact of the etiology and Vitamin D receptor TaqI rs731236 gene polymorphism on the severity of acute pancreatitis. J Hepatobiliary Pancreat Sci. 2020;27(11):896–906. Cieślińska A, Kostyra E, Fiedorowicz E, Snarska J, Kordulewska N, Kiper K, Savelkoul HFJ. Single Nucleotide Polymorphisms in the Vitamin D Receptor Gene (VDR) May Have an Impact on Acute Pancreatitis (AP) Development: A Prospective Study in Populations of AP Patients and Alcohol-Abuse Controls. Int J Mol Sci. 2018;19(7):1919. Skipworth JR, Nijmeijer RM, van Santvoort HC, Besselink MG, Schulz HU, Kivimaki M, Kumari M, Cooper JA, Acharya J, Shankar A, Malago M, Humphries SE, Olde Damink SW, Montgomery HE. The effect of renin angiotensin system genetic variants in acute pancreatitis. Ann Surg. 2015;261(1):180–8. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 23 Feb, 2026 Reviewers invited by journal 17 Feb, 2026 Editor invited by journal 21 Jan, 2026 Editor assigned by journal 09 Dec, 2025 Submission checks completed at journal 09 Dec, 2025 First submitted to journal 07 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8300548","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":593138066,"identity":"7922212e-6f3a-43eb-824c-fdd2472dc980","order_by":0,"name":"Fei Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA20lEQVRIiWNgGAWjYBACfvnjx3///Gcjx8/efIA4LZIzeBKkGdjSjCV7jiUQp8XgBoMBUMvhRIMbOQZEuux2Q4JxAc/hBIYzZz7eeMNgJ6fbQEAH45yDB5JnSKTnMbb3bracw5BsbHaAgBZmhoSEAzwG1sXMPGe3SfMwHEjcRkgLG0OCYQNPAnNim0TOM+K08EgkGDPzHHBO7JHIYSNOiwTPmTTGmQ1pxhI8x4wt5xgQ4Rf74+3HGD422MjZH29+eONNhZ0cQS1oVhIbNUhaSNUxCkbBKBgFIwIAAOueQ8zjP+qrAAAAAElFTkSuQmCC","orcid":"","institution":"Second Affiliated Hospital of Nanchang University","correspondingAuthor":true,"prefix":"","firstName":"Fei","middleName":"","lastName":"Zhang","suffix":""},{"id":593138067,"identity":"b37116cc-aa54-47d9-b99c-eb4d35fbb5ed","order_by":1,"name":"Weijuan Hu","email":"","orcid":"","institution":"Second Affiliated Hospital of Nanchang University","correspondingAuthor":false,"prefix":"","firstName":"Weijuan","middleName":"","lastName":"Hu","suffix":""},{"id":593138069,"identity":"b301ae0a-75c5-4852-96f9-63e600a29858","order_by":2,"name":"Yonghao Ouyang","email":"","orcid":"","institution":"Jinling Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yonghao","middleName":"","lastName":"Ouyang","suffix":""}],"badges":[],"createdAt":"2025-12-07 14:53:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8300548/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8300548/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103167191,"identity":"7f5aefef-6ec6-4025-9131-a92f1603f199","added_by":"auto","created_at":"2026-02-22 12:44:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":120471,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart for participants in MIMIC-IV(V 3.1)\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8300548/v1/558a9de3a3f9ac8306c3bf58.png"},{"id":103505281,"identity":"d43ad38e-821f-4110-bd92-66bdf8262158","added_by":"auto","created_at":"2026-02-26 13:29:20","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":164270,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan-Meier curve for mortality. A 28-day mortalty B 90-day mortality\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8300548/v1/e34e0d62477b7475f156a51e.png"},{"id":103167193,"identity":"58acdccb-3b00-4918-a3c2-417a53c78724","added_by":"auto","created_at":"2026-02-22 12:44:35","extension":"jpeg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":624127,"visible":true,"origin":"","legend":"\u003cp\u003eSubgroup analysis of multivariable-adjusted HR pertaining to the association between the Vitamin D and AP. \u0026nbsp;A 28-day mortality \u0026nbsp;B 90-day mortality\u003c/p\u003e","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8300548/v1/023add0de06c6c8ff07a6784.jpeg"},{"id":104397431,"identity":"8c546b58-3aad-4c48-a71e-3f183344b718","added_by":"auto","created_at":"2026-03-11 11:48:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2092029,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8300548/v1/9400b253-30a6-4d84-b508-7d68c5f4f8ec.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Vitamin D supplementation is associated with improved outcomes in critically ill patients with acute pancreatitis in the intensive care unit: a retrospective analysis based on the MIMIC-IV database","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAcute pancreatitis (AP) is a prevalent gastrointestinal disorder triggered by various causes that induce the aberrant activation of pancreatic enzymes, leading to pancreatic and peri-pancreatic tissue damage and necrosis[\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The principal causes are gallstones, alcohol and hypertriglyceridaemia[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Most patients present with mild symptoms, such as abdominal pain, bloating, nausea and vomiting, and the condition usually resolves spontaneously[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, about 20% of patients progress to moderate or severe acute pancreatitis, which may produce pancreatic or peripancreatic necrosis, provoke a systemic inflammatory response syndrome and even cause multiple organ failure, with mortality as high as 30%[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Early assessment of disease severity and prompt, effective treatment are therefore of great clinical importance to improve survival.\u003c/p\u003e \u003cp\u003eVitamin D is an important fat-soluble vitamin in humans. It is synthesized in the skin and undergoes two hydroxylations in the liver and kidneys to produce the active form 1,25-dihydroxyvitamin D (1,25-(OH)\u003csub\u003e2\u003c/sub\u003eD)[\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. 1,25-(OH)₂D binds to the vitamin D receptor (VDR) in cells and mediates complex biological functions by regulating the transcription and expression of target genes[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Not only does vitamin D play a crucial role in bone metabolism, it also plays a key role in the immune system[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Immune cells, including activated T and B lymphocytes, neutrophils, and antigen-presenting cells, have been observed to express hydroxylase and the VDR[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. A plethora of studies have demonstrated a correlation between vitamin D deficiency and an elevated risk and severity of a multitude of diseases, including infections, autoimmune diseases, cardiovascular diseases, tumours, sarcopenia, osteoarthritis, and transplant rejection[\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. There is currently no study or evidence to show whether vitamin D supplementation can improve the prognosis of patients with AP. Therefore, the objective of this study is to investigate the possible therapeutic benefits of vitamin D on the clinical outcomes of patients with AP, drawing upon the MIMIC Ⅳ database. This will provide more evidence for the clinical use of vitamin D and thus help improve prognosis.\u003c/p\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData sources\u003c/h2\u003e \u003cp\u003eThe data for this study were obtained from the the Medical Information Mart for Intensive Care IV ver 3.1 (MIMIC-IV, version 3.1) database, a large, publicly available resource developed by the Massachusetts Institute of Technology\u0026rsquo;s Laboratory of Computational Physiology. (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://physionet.org/content/mimiciv/3.1/\u003c/span\u003e\u003cspan address=\"https://physionet.org/content/mimiciv/3.1/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e)[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The database comprises records of patients with AP admitted to Beth Israel Deaconess Medical Center (BIDMC) from 2008 to 2022, and includes demographics, length of hospital stay, laboratory tests, medication treatment, vital signs and related information. To protect patients' privacy, all patients' personal information in this database had been de-identified, therefore, this study did not require patients' informed consent or ethical approval. The first author of this study, Fei Zhang, obtained access to the MIMIC-IV database by completing the Collaborative Institutional Training Initiative (CITI) programme (citiprogram.org) in accordance with relevant guidelines and regulations, and by passing the \"Conflict of Interest\" and \"Data or Specimens Only Research\" examinations (ZF, certification number 69083165).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePopulation selection criteria\u003c/h3\u003e\n\u003cp\u003eThe MIMIC-IV database contained a total of 546,028 hospitalization records, among which 94,458 were admitted to the ICU. Patients diagnosed with AP were identified using the International Classification of Diseases, Ninth Revision (ICD-9) code 577.0 and Tenth Revision (ICD-10) codes K85-K85.92, resulting in the inclusion of 7312 patients. Among these, 1,280 were admitted to the ICU. Further screening excluded patients meeting the following criteria: (1) age under 18 years at first admission; (2) repeated admissions for acute pancreatitis, retaining only the first admission data; (3) ICU stay duration less than 24 hours. Ultimately, 1068 patients were included in this study (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eData extraction\u003c/h3\u003e\n\u003cp\u003eThe MIMIC-IV version 3.1 database recorded demographic variables such as patient age, sex, and race. Documented vital signs included heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), respiratory rate (RR), saturation of peripheral oxygen (SpO2), and body temperature. Recorded clinical interventions comprised statins, octreotide, vasopressin, β-blockers, mechanical ventilation, continuous renal replacement therapy (CRRT), and endoscopic retrograde cholangiopancreatography (ERCP). Admission complications were also annotated, including acute kidney injury (AKI), sepsis, respiratory failure (RF), heart failure (HF), atrial fibrillation (AF), hypertension, diabetes (DM), and obesity. Laboratory measurements included haematocrit (HCT), haemoglobin (HB), platelet count (PLT), red cell distribution width (RDW), red blood cell count (RBC), white blood cell count (WBC), albumin (ALB), anion gap, serum potassium, serum sodium, serum calcium, lactate (Lac), international normalised ratio (INR), prothrombin time (PT), glucose (GLU), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), creatinine (Cr), and blood urea nitrogen. All values correspond to the first test results performed after ICU admission with the initial 24h. Data were extracted by executing structured query language (SQL) and Navicat Premium software (Version 16).\u003c/p\u003e\n\u003ch3\u003eOutcomes\u003c/h3\u003e\n\u003cp\u003eThe primary outcome was 28-day all-cause mortality, and the secondary outcomes included 90-day all-cause mortality.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eVariables with less than 20% missing data, were handled by single imputation methods. Normally distributed continuous variables are expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, and groups were compared using independent samples t-test. Non-normally distributed continuous variables are presented as median (interquartile range), and intergroup comparisons were performed with the Mann-Whitney U test. Categorical variables are reported as frequency and percentage, and group differences were assessed with the χ2 test. The KM curve and the log-rank test were used to evaluate whether vitamin D supplementation improved prognosis in patients with AP. We then fitted two COX proportional hazards models to examine the effect of vitamin D on outcomes. Model I adjusted for patient age, sex, SpO\u003csub\u003e2\u003c/sub\u003e, HF, RF, vasopressin, RDW, PT, and Cr to account for their potential influence on outcomes. Subgroup analyses were performed to assess the robustness of the association between vitamin D and outcomes across age, sex, HF, RF, and vasporession use.\u003c/p\u003e \u003cp\u003eData analysis in this study was performed using Free statistics software version 2.1. A two-sided value of \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered to indicate statistical significance.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eBaseline demographic and clinical characteristics\u003c/h2\u003e \u003cp\u003eA total of 1,280 patients with AP admitted to the ICU were included in the analysis. Of these, 131 patients received vitamin D treatment, and 937 patients did not. The mean age of the cohort was 58.7\u0026thinsp;\u0026plusmn;\u0026thinsp;17.3 years, with males accounting for 57.5% of the participants.\u003c/p\u003e \u003cp\u003eBaseline patient characteristics are presented in Table\u0026nbsp;1. Patients in the non-vitamin D group were more likely to have hypertension but less likely to have HF and AKI. This group also had higher HCT, HB, RBC, and sodium and lower RDW, calcium, INR and PT than the vitamin D group. Statins and vasopressors were more frequently used in the vitamin D group, while the remaining covariates did not differ significantly between groups.\u003c/p\u003e \u003c/div\u003e\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Baseline patient characteristics in patients with acute pancreatitis.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"128%\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eTotal (n = 1068)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003eNon-vitaminD (n = 937)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eVitaminD (n = 131)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e58.7 \u0026plusmn; 17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e58.9 \u0026plusmn; 17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e57.5 \u0026plusmn; 17.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.394\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e614 (57.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e552 (58.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e62 (47.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e454 (42.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e385 (41.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e69 (52.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 23px;\"\u003e\n \u003cp\u003eRace, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eWhite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e668 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e586 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e82 (62.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.453\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eBlack\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e109 (10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e91 (9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e18 (13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e130 (12.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e117 (12.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eUnkown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e161 (15.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e143 (15.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e18 (13.7)\u003c/p\u003e\n \u003c/td\u003e\u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVital signs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eHR, beats/minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e100.7 \u0026plusmn; 21.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e100.8 \u0026plusmn; 21.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e100.2 \u0026plusmn; 20.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.749\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eSBP, mmHg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e125.6 \u0026plusmn; 25.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e126.3 \u0026plusmn; 25.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e120.3 \u0026plusmn; 24.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eDBP, mmHg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e73.2 \u0026plusmn; 19.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e73.7 \u0026plusmn; 19.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e69.3 \u0026plusmn; 18.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eMAP, mmHg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e85.9 \u0026plusmn; 19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e86.4 \u0026plusmn; 19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e81.8 \u0026plusmn; 19.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eRR, beats/minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e21.4 \u0026plusmn; 6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e21.3 \u0026plusmn; 6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e22.2 \u0026plusmn; 7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eSpO2, %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e96.1 \u0026plusmn; 4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e96.0 \u0026plusmn; 4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e96.6 \u0026plusmn; 3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.128\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eTemperature, ℃\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e36.9 \u0026plusmn; 1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e36.9 \u0026plusmn; 2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e36.8 \u0026plusmn; 0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.933\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaboratory Indicators\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eHCT, %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e33.4 \u0026plusmn; 7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e33.8 \u0026plusmn; 7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e31.1 \u0026plusmn; 7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eHB, g/dL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e11.0 \u0026plusmn; 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e11.2 \u0026plusmn; 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e10.2 \u0026plusmn; 2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003ePLT, 10^\u003csup\u003e9\u003c/sup\u003e/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e215.5 \u0026plusmn; 136.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e215.9 \u0026plusmn; 135.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e213.3 \u0026plusmn; 141.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.839\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eRDW, %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e15.4 \u0026plusmn; 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e15.3 \u0026plusmn; 2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e16.4 \u0026plusmn; 2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eRBC, 10^\u003csup\u003e12\u003c/sup\u003e/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e3.6 \u0026plusmn; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e3.7 \u0026plusmn; 0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e3.3 \u0026plusmn; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eWBC, 10^\u003csup\u003e9\u003c/sup\u003e/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e14.3 \u0026plusmn; 8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e14.4 \u0026plusmn; 8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e14.0 \u0026plusmn; 8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.616\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eALB, g/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e28.4 \u0026plusmn; 6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e28.4 \u0026plusmn; 6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e28.7 \u0026plusmn; 6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.582\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eAnion_gap, mEq/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e16.1 \u0026plusmn; 5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e16.1 \u0026plusmn; 5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e16.1 \u0026plusmn; 5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.942\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eCalcium, mEg/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e8.0 \u0026plusmn; 1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e8.0 \u0026plusmn; 1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e8.2 \u0026plusmn; 1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003ePotassium, mEg/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e4.2 \u0026plusmn; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e4.2 \u0026plusmn; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e4.1 \u0026plusmn; 0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.234\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eSodium, mEg/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e137.9 \u0026plusmn; 6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e138.1 \u0026plusmn; 6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e136.6 \u0026plusmn; 6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eLac, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e1.8 (1.3, 2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.8 (1.3, 2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e1.8 (1.3, 2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.916\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eINR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e1.6 \u0026plusmn; 1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.6 \u0026plusmn; 1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e1.8 \u0026plusmn; 1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003ePT, sec\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e17.4 \u0026plusmn; 10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e17.1 \u0026plusmn; 10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e19.7 \u0026plusmn; 11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eGLU, mmol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e7.0 (6.0, 10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e7.0 (6.0, 10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e7.0 (6.0, 9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.511\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eALT, IU/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e45.5 (23.0, 129.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e47.0 (24.0, 136.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e40.0 (20.0, 97.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eAST, IU/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e68.0 (32.2, 164.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e67.0 (32.0, 166.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e73.0 (34.2, 142.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eTBIL, \u0026mu;mol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e17.1 (8.6, 47.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e17.1 (8.6, 46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e20.5 (10.3, 59.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eCre, \u0026mu;mol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e97.2 (61.9, 168.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e97.2 (61.9, 168.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e97.2 (61.9, 194.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.937\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eUrea_nitrogen, mg/dL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e20.0 (12.0, 37.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e20.0 (12.0, 36.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e23.0 (12.0, 40.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.543\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComorbidity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eSepsis3, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e720 (67.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e631 (67.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e89 (67.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.891\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eAKI, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e721 (67.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e619 (66.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e102 (77.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eHypertension, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e464 (43.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e419 (44.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e45 (34.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eDM, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e311 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e273 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e38 (29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.976\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eHF, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e197 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e163 (17.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e34 (26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eObesity, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e146 (13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e122 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e24 (18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.098\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eAF, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e224 (21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e196 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e28 (21.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.904\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eRF, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e444 (41.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e398 (42.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e46 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eStatin, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e95 ( 8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e73 (7.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e22 (16.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eOctreotide, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e115 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e93 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e22 (16.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eVasopressin, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e241 (22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e205 (21.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e36 (27.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eBetablockers, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e545 (51.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e479 (51.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e66 (50.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.874\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eVentilation, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e866 (81.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e756 (80.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e110 (84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.368\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eCRRT, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e156 (14.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e135 (14.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e21 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.622\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eERCP, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e28 ( 2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e23 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e5 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.376\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinical outcome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003e28-day mortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e136 (12.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e123 (13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e13 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.303\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003e90-day mortality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e185 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e162 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e23 (17.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.939\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviation: HR, heart rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; RR, respiratory rate; Spo2, saturation of peripheral oxygen; HCT, haematocrit; HB, haemoglobin, PLT, platelet count, RDW, red cell distribution width; RBC, red blood cell count; WBC, white blood cell count; ALB, albumin; Lac, lactate; INR, international normalized ratio; PT, prothrombin time, GLU, glucose; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TBIL, total bilirubin; Cre, creatinine; AKI, acute kidney injury; DM, diabetes; HF, heart failure; AF, atrial fibrillation; RF, respiratory failure; CRRT, continuous renal replacement therapy; ERCP, endoscopic retrograde cholangiopancreatography.\u003c/p\u003e\n\u003ch3\u003eUnivariate and multivariate COX regression models of vitamin D with mortality in patients with AP\u003c/h3\u003e\n\u003cp\u003eFirst, univariate Cox regression, identified variables significantly associated with 28-day and 90-day mortality (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e). We then performed collinearity analysis and retained variables with VIF\u0026thinsp;\u0026lt;\u0026thinsp;5, as candidates for multivariable modelling. The multivariate Cox model was adjusted for clinically relevant factors and included variables that were significant in the univariate analysis and had VIF\u0026thinsp;\u0026lt;\u0026thinsp;5 in the collinearity assessment.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis of risk factor associated with 28-day and 90-day mortality in patients with AP.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e28-day Mortality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e90-day Mortality\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHR\u003c/p\u003e \u003cp\u003e(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003cp\u003e(Wald's test)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003cp\u003e(LR-test)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHR\u003c/p\u003e \u003cp\u003e(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003cp\u003e(Wald's test)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003cp\u003e(LR-test)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.03 (1.02, 1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.99 (0.7, 1.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.947\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.947\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.661\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.662\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRace\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.45 (0.2, 1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.54 (0.29, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.77 (0.43, 1.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.376\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.53 (0.3, 0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.71 (1.15, 2.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.35 (0.95, 1.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.089\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.9925 (0.985, 1.0001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.9922 (0.9859, 0.9985)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSBP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.98 (0.98, 0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.99 (0.98, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDBP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.98 (0.97, 0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.99 (0.98, 0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMAP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.98 (0.98, 0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.99 (0.98, 0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.0083 (0.9846, 1.0327)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.495\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.498\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.9973 (0.9767, 1.0184)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.801\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.801\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpO2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.96 (0.93, 0.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.95 (0.93, 0.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTemperature\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.92 (0.89, 0.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.92 (0.89, 0.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.9905 (0.9692, 1.0122)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.388\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.385\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.99 (0.97, 1.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.95 (0.89, 1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.95 (0.89, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePLT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.9986 (0.9972, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.9988 (0.9977, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRDW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.14 (1.09, 1.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.14 (1.1, 1.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.84 (0.69, 1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.082\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.88 (0.74, 1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.03 (1.01, 1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.03 (1.01, 1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.97 (0.95, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.98 (0.95, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnion_gap\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.08 (1.05, 1.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.06 (1.03, 1.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalcium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.04 (0.91, 1.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.536\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.01 (0.91, 1.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.795\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.795\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePotassium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.32 (1.12, 1.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.23 (1.07, 1.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSodium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.0046 (0.9781, 1.0318)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.738\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.738\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.9983 (0.9763, 1.0209)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.884\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.884\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLac\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.18 (1.14, 1.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.15 (1.11, 1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eINR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.19 (1.07, 1.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.19 (1.08, 1.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.02 (1.01, 1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.02 (1.01, 1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGLU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.9974 (0.9692, 1.0264)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.858\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.855\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.9901 (0.9629, 1.018)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.483\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.458\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.9998, 1.0002)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.945\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.945\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (0.9997, 1.0002)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.723\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.711\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAST\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.0001 (1, 1.0001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (1, 1.0001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.326\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBIL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.0028 (1.0019, 1.0036)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0023 (1.0015, 1.0031)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.0018 (1.0011, 1.0025)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0014 (1.0008, 1.0021)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrea_nitrogen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.01 (1.01, 1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.01 (1.01, 1.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSepsis3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.14 (1.32, 3.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.8 (1.21, 2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAKI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.32 (2.19, 8.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.99 (1.79, 5.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.75 (0.53, 1.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.74 (0.54, 1.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.02 (0.7, 1.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.02 (0.75, 1.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.881\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.882\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.65 (1.13, 2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.64 (1.17, 2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObesity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.15 (0.73, 1.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.555\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.561\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.11 (0.75, 1.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.593\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.597\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.54 (1.07, 2.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.73 (1.27, 2.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.86 (1.3, 2.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.7 (1.25, 2.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.64 (0.31, 1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63 (0.35, 1.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOctreotide\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.6 (1.05, 2.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.14 (0.78, 1.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.499\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVasopressin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.88 (4.04, 8.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.81 (2.79, 5.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBetablockers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.43 (0.31, 0.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.53 (0.4, 0.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVentilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.24 (0.71, 2.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.449\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.436\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.19 (0.74, 1.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.467\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.456\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRRT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.58 (2.54, 5.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.64 (1.96, 3.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eERCP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.91 (0.84, 4.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.56 (0.73, 3.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.283\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitaminD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.56 (0.32, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.62 (0.4, 0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe 28-day mortality was lower in the vitamin D group than in the non-vitamin D group, with a hazard ratio of 0.56 (95% CI 0.32-1, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.048). Similarly, the 90-day mortality was lower in the vitamin D group than in the non-vitamin D group, with a hazard ratio of 0.62 (95% CI 0.4\u0026ndash;0.96, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.031) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariant Cox regression models of Vitamin D with mortality in patients with AP.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOutcomes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eUnadjusted\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003e28-day Mortality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-Vitamin D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitamin D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.56 (0.32\u0026thinsp;~\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.29 (0.15\u0026thinsp;~\u0026thinsp;0.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003e90-day Mortality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-Vitamin D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitamin D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.62 (0.4\u0026thinsp;~\u0026thinsp;0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.33 (0.2\u0026thinsp;~\u0026thinsp;0.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eModel 1: Adjusted for age, gender, SpO2, HF, RF, vasopression, RDW, PT, TBIL, Cr.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAfter adjusting for clinically relevant covariates, the association between vitamin administration and reduced mortality remained significant. The adjusted hazard ratio for 28-day mortality was 0.54 (95% CI 0.42\u0026ndash;0.69, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and for 90-day mortality, it was 0.64 (95% CI 0.52\u0026ndash;0.77, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) ( Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eKaplan-Meier curve analysis\u003c/h2\u003e \u003cp\u003eThe KM survial curves demonstrated that vitamin D group had lower mortality at 28-day, and 90-day compared to the non-vitamin D group (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSubgroup analyses for the vitamin D on clinical outcomes in patients with AP\u003c/h2\u003e \u003cp\u003eWhen the subgroups were analyzed according to age, sex, hypertension, RF, and vasopressin, the forest plots showed no interaction between vitamin D and most of the subgroups. However, there was an interaction at 28-day and 90-day mortality in the hypertension subgroup. The results are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eAs one of the common diseases in the digestive system, the prognosis of patients with AP varies significantly depending on the severity of the disease\u003csup\u003e5\u003c/sup\u003e. Vitamin D has immunomodulatory and anti-inflammatory properties, which may improve the prognosis of AP\u003csup\u003e15,20\u003c/sup\u003e. To date, no consensus exists on whether vitamin D supplementation improves the prognosis of critically ill patients with AP. Consequently, we conducted a large retrospective cohort study using the MIMIC-IV v 3.1 database.\u003c/p\u003e \u003cp\u003eNumerous studies have demonstrated a correlation between vitamin D and AP. Abou et al. found that patients with AP have significantly higher rates of vitamin D deficiency, osteoporosis, and fracture risk compared to the general population[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Besides studies by Huh et al., Bang et al., and Leerh\u0026oslash;y et al. also reported a high prevalence of vitamin D deficiency among patients with AP[\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Although numerous studies have demonstrated a correlation between AP and vitamin D, most of these findings indicate unidirectional causality between the two. Few researchers have investigated the prognostic relationship between vitamin D and AP. The Cox regression analysis in this study revealed that vitamin D supplementation serves as an independent protective factor against AP. Previous studies by Cates et al. and Kim et al. in animals revealed a positive correlation between decreased 25(OH)D levels and the mortality rate of AP[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. This conclusion supports the results of this study. This finding was also corroborated in the study by Huh et al.[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Some studies indicate that hypercalcemia induced by vitamin D deficiency may also increase the risk of AP[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eKM analysis revealed that patients with AP who received vitamin D supplementation had a lower risk of death compared to those who did not. Current research on the impact of vitamin D supplementation on the prognosis of acute pancreatitis remains limited. Previous study by Sharma et al. found that vitamin D supplementation can reduce the risk of AP multi-organ failure[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. This conclusion supports the results of our study. However, the inclusion of only 87 patients may be subject to significant bias.\u003c/p\u003e \u003cp\u003eThe mechanism underlying the relationship between vitamin D and AP remains incompletely understood. Studies have shown a correlation between vitamin D deficiency and exacerbated of the inflammatory response in individuals with AP, leading to poorer clinical outcomes[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan additionalcitationids=\"CR31\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Cai et al. suggest that vitamin D's anti-inflammatory and anti-fibrotic effects may be crucial for maintaining pancreatic homeostasis[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Kwong et al. and Woods et al. found that vitamin D deficiency-mediated hypercalcemia caused by CYP24A1 mutations increases the risk of AP[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Furthermore, polymorphisms in the VDR gene may also influence the severity and prognosis of AP[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. The potential mechanism may also involve the interaction between vitamin D and the renin-angiotensin system (RAS)[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo the best of our knowledge, this is the first large-scale clinical study to investigate the association between vitamin D supplementation and clinical outcomes in patients with AP admitted to the ICU. The strengths of our study are noteworthy. First, we utilized the comprehensive MIMIC-IV database, which provided a substantial sample size and enhanced the generalizability of our findings. Second, we employed rigorous statistical methodologies, including multivariate Cox proportional hazards models and KM survival analysis, to robustly establish the independent protective association of vitamin D. Finally, we performed subgroup analyses to assess the consistency of this association across different patient populations, thereby strengthening the reliability of our conclusions.\u003c/p\u003e \u003cp\u003eHowever, several limitations inherent to our study design must be acknowledged. First and foremost, this was a retrospective observational study. Although we adjusted for numerous clinically relevant confounders, unmeasured or residual confounding factors (e.g., nutritional status, detailed etiology of AP, or other concomitant treatments) could still influence the observed associations. Second, our analysis was based on diagnostic codes (ICD-9 and ICD-10) for patient identification, which, while standard for database studies, may be subject to coding inaccuracies or variability. Third, and critically, our data lacked information on baseline serum 25-hydroxyvitamin D levels. Consequently, we could not determine if the observed benefit was due to the correction of a pre-existing deficiency or a pharmacological effect of supplementation. Furthermore, details regarding the specific dosage, formulation, duration, and timing of vitamin D administration were not available, limiting the clinical translatability of our findings. Future prospective, randomized controlled trials are essential to confirm these results, define the optimal therapeutic regimen (including target patient population based on vitamin D status, dosage, and timing), and elucidate the underlying biological mechanisms.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, this study compared the prognosis of AP patients receiving vitamin D supplementation versus those not receiving it using the MIMIC-IV database, demonstrating that vitamin D significantly improves patient outcomes. This study provides a theoretical basis for vitamin D supplementation during antipsychotic treatment. However, large-scale, multicenter prospective studies are still needed to verify this.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAcute pancreatitis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICU\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIntensive care unit\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMIMIC-IV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMedical Information Mart for Intensive care IV\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eKaplan-Meier\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eKM\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e1,25-dihydroxyvitamin D\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003e1,25-(OH)\u003csub\u003e2\u003c/sub\u003eD\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eVitamin D receptor\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eVDR\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHeart rate\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSBP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSystolic blood pressure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDBP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDiastolic blood pressure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMAP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMean arterial pressure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRespiratory rate\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSpO2\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSaturation of peripheral oxygen\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCRRT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eContinuous renal replacement therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eERCP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEndoscopic retrograde cholangiopancreatography\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAKI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAcute kidney injury\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRespiratory failure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHeart failure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAtrial fibrillation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHaematocrit\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHaemoglobin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePLT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePlatelet count\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRDW\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRed cell distribution width\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRBC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRed blood cells count\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWBC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWhite blood cells count\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eALB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAlbumin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLac\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLactate\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eINR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInternational normalized ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eProthrombin time\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGLU\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGlucose\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eALT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAlanine aminotransferase\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAST\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAspartate aminotransferase\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTBIL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTotal bilirubin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCr\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCreatinine\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe acknowledged the contributions of the MIMIC-IV (version 3.1) program registry for creating and updating the MIMIC-IV database.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFei Zhang created the study protocol, performed the statistical analyses and wrote the first manuscript draft. Weijuan Hu assisted with the study design, performed date collection and revised the manuscript. Yonghao Ouyang critically revised the manuscript. All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets analysed during the current study are available in the MIMIC-IV repository, https://physionet.org/content/mimiciv/3.1/.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo protect patients\u0026apos; privacy, all patients\u0026apos; personal information in this database had been de-identified, therefore, this study did not require patients\u0026apos; informed consent or ethical approval.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCai F, Hu C, Chen CJ, Han YP, Lin ZQ, Deng LH, Xia Q. Vitamin D and Pancreatitis: A Narrative Review of Current Evidence. Nutrients. 2022;14(10):2113.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoyal H, Awad H, Hu ZD. Prognostic value of admission red blood cell distribution width in acute pancreatitis: a systematic review. Ann Transl Med. 2017;5(17):342.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMihoc T, Latcu SC, Secasan CC, Dema V, Cumpanas AA, Selaru M, Pirvu CA, Valceanu AP, Zara F, Dumitru CS, Novacescu D, Pantea S. Pancreatic Morphology, Immunology, and the Pathogenesis of Acute Pancreatitis. Biomedicines. 2024;12(11):2627.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSzatmary P, Grammatikopoulos T, Cai W, Huang W, Mukherjee R, Halloran C, Beyer G, Sutton R. Acute Pancreatitis: Diagnosis and Treatment. 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Vitamin D's Role in Cardiovascular Diseases. Discov Med. 2024;36(189):1973\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJohnson AEW, Bulgarelli L, Shen L, Gayles A, Shammout A, Horng S, Pollard TJ, Hao S, Moody B, Gow B, Lehman LH, Celi LA, Mark RG. MIMIC-IV, a freely accessible electronic health record dataset. Sci Data. 2023;10(1):1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChang SW, Lee HC. Vitamin D and health - The missing vitamin in humans. Pediatr Neonatol. 2019;60(3):237\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbou Saleh M, Alkhayyat M, Mansoor E, Khoudari G, Simons-Linares CR, Vargo J, Chahal P, Stevens T. The Risk of Vitamin D Deficiency, Osteoporosis, and Fractures in Acute Pancreatitis. Pancreas. 2020;49(5):629\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuh JH, Kim JW, Lee KJ. Vitamin D deficiency predicts severe acute pancreatitis. 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PMID: 2456625.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim DI, Kim H, Son P, Kang JH, Kang BT, Yang MP. Serum 25-hydroxyvitamin D concentrations in dogs with suspected acute pancreatitis. J Vet Med Sci. 2017;79(8):1366\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTešić-Rajković S, Radovanović-Dinić B, Mitić B, Dinić-Radović V, Jovanović M. Hyperparathyroidism as a cause of recurrent acute pancreatitis: A case report. Vojnosanit Pregl. 2016;73(11):1064\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaif A. Primary hyperparathyroidism presenting with acute pancreatitis and asymptomatic bone involvement. 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Impact of the etiology and Vitamin D receptor TaqI rs731236 gene polymorphism on the severity of acute pancreatitis. J Hepatobiliary Pancreat Sci. 2020;27(11):896\u0026ndash;906.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCieślińska A, Kostyra E, Fiedorowicz E, Snarska J, Kordulewska N, Kiper K, Savelkoul HFJ. Single Nucleotide Polymorphisms in the Vitamin D Receptor Gene (VDR) May Have an Impact on Acute Pancreatitis (AP) Development: A Prospective Study in Populations of AP Patients and Alcohol-Abuse Controls. Int J Mol Sci. 2018;19(7):1919.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSkipworth JR, Nijmeijer RM, van Santvoort HC, Besselink MG, Schulz HU, Kivimaki M, Kumari M, Cooper JA, Acharya J, Shankar A, Malago M, Humphries SE, Olde Damink SW, Montgomery HE. The effect of renin angiotensin system genetic variants in acute pancreatitis. Ann Surg. 2015;261(1):180\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Vitamin D, Acute pancreatitis, Mortality, MIMIV-IV database","lastPublishedDoi":"10.21203/rs.3.rs-8300548/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8300548/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAcute pancreatitis (AP) is a common gastrointestinal emergency, and its progression to severe forms in the intensive care unit (ICU) is associated with high mortality. Vitamin D, beyond its classical role in bone metabolism, possesses significant immunomodulatory and anti-inflammatory properties. Although numerous studies have found that vitamin D supplementation may improve prognoses in critically ill patients, no research to date has demonstrated a benefit in patients with AP. Therefore, this study examined the association between vitamin D supplementation and mortality in ICU patients with AP.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis retrospective cohort study utilized data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Adult ICU patients diagnosed with AP were included. Patients were categorized into vitamin D and non-vitamin D groups based on supplementation during their ICU stay. The primary and secondary outcomes were 28-day and 90-day all-cause mortality, respectively. Associations were assessed using Kaplan-Meier (KM) survival curves and multivariable Cox proportional-hazards models, with adjustments for relevant demographic, clinical, and laboratory confounders.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe study finally included 1068 patients with AP, comprising 131 and 937 in the vitamin D and non-vitamin D groups, respectively. The KM survival curves indicated that the survival probability differed significantly between the two groups. Following multivariate COX regression, which was adjusted for confounding factors, the hazard ratio (95% confidence interval) values for 28-day and 90-day mortality in the vitamin D group were 0.29 (0.15, 0.55) and 0.33 (0.2, 0.54), respectively.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eIn this retrospective analysis, vitamin D supplementation was independently associated with a significant reduction in 28-day and 90-day mortality among ICU patients with AP. Given the favourable safety profile and low cost of vitamin D, these findings warrant confirmation in large-scale, prospective randomised controlled trials to establish a potential causal relationship and guide clinical practice.\u003c/p\u003e","manuscriptTitle":"Vitamin D supplementation is associated with improved outcomes in critically ill patients with acute pancreatitis in the intensive care unit: a retrospective analysis based on the MIMIC-IV database","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-22 12:44:27","doi":"10.21203/rs.3.rs-8300548/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"205217509749618260600422551060856877498","date":"2026-02-23T11:10:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-17T09:05:32+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-21T11:24:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-09T06:52:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-09T06:50:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Gastroenterology","date":"2025-12-07T14:38:45+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"85f7577c-12f2-4f66-8df8-a7120a22b3bf","owner":[],"postedDate":"February 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-22T12:44:28+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-22 12:44:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8300548","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8300548","identity":"rs-8300548","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}