Research Article
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An Independent Predictor of Mortality in Hospitalized Patients: Vitamin B12

Year 2024, Volume: 4 Issue: 3, 64 - 70, 29.07.2024
https://doi.org/10.56016/dahudermj.1494846

Abstract

Objectives: Increased vitamin B12 levels are associated with mortality. We aim to define the relationship between B12 levels and 6 months,12 months, and 48 months mortality.
Methods: We investigated 455 patients hospitalized in the internal medicine clinic from 01.01.2014 to 30.06.2014. Patients younger than 18 years old, with chronic heart failure, hematological malignancies, solid tumors, chronic liver disease, and end-stage kidney disease were excluded. Patients with a vitamin B12 below and below the reference range were excluded. Laboratory parameters and vitamin B12 levels were compared between survival and non-survival groups at 6 months,12 months, and 48 months. Mortality data for 6 months,12 months, and 48 months after the first hospitalization day were obtained.
Results: The mortality percentages of patients were evaluated on the 6th, 12th, and 48th months. Age, complete blood count parameters (hemoglobin, white blood cell, and platelet), acute phase reactants, and serum vitamin B12 levels were compared between patient groups. Increased vitamin B12 level was found to be correlated with acute phase reactants (C reactive protein, albumin, ferritin, sedimentation) and hemoglobin. Regression analysis revealed that increased vitamin B12 levels, ferritin, sedimentation, white blood cell, and low albumin levels were statistically significant in 6th-month mortality. High white blood cell count and low albumin levels were statistically significantly correlated with mortality in the 12th and 48th months.
Conclusion: Increased vitamin B12 levels were effective in predicting 6-month, 12-month, and 48-month mortality. Age-decreased albumin levels, acute phase reactants, and increased B12 levels were identified in hospitalized patients as risk factors for short, mid-term, and long-term mortality.

References

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  • Murray K, Rodwell V, Bender D, Botham KM, Weil PA, Kennelly P J. Harper's illustrated biochemistry. 28. Citeseer, New York, United States. The McGraw-Hill Companies 2009
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  • Smith AD, Refsum H. Vitamin B-12 and cognition in the elderly. Am J Clin Nutr. 2009 Feb;89(2):707S-11S. doi: 10.3945/ajcn.2008.26947D. Epub 2008 Dec 30.
  • Ermens AA, Vlasveld LT, Lindemans J. Significance of elevated cobalamin (vitamin B12) levels in blood. Clin Biochem. 2003 Nov;36(8):585-90. doi: 10.1016/j.clinbiochem.2003.08.004.
  • Gimsing P, Hippe E. Increased concentration of transcobalamin I in a patient with metastatic carcinoma of the breast. Scand J Haematol. 1978 Sep;21(3):243-9. doi: 10.1111/j.1600-0609.1978.tb00359.x.
  • Salles N, Herrmann F, Sakbani K, Rapin CH, Sieber C. High vitamin B12 level: a strong predictor of mortality in elderly inpatients. J Am Geriatr Soc. 2005 May;53(5):917-8. doi: 10.1111/j.1532-5415.2005.53278_7.x.
  • Geissbühler P, Mermillod B, Rapin CH. Elevated serum vitamin B12 levels associated with CRP as a predictive factor of mortality in palliative care cancer patients: a prospective study over five years. J Pain Symptom Manage. 2000 Aug;20(2):93-103. doi: 10.1016/s0885-3924(00)00169-x.
  • Dou J, Xu W, Ye B, Zhang Y, Mao W. Serum vitamin B12 levels as indicators of disease severity and mortality of patients with acute-on-chronic liver failure. Clin Chim Acta. 2012 Nov 20;413(23-24):1809-12. doi: 10.1016/j.cca.2012.07.008.
  • Oh HK, Lee JY, Eo WK, Yoon SW, Han SN. Elevated Serum Vitamin B12 Levels as a Prognostic Factor for Survival Time in Metastatic Cancer Patients: A Retrospective Study. Nutr Cancer. 2018 Jan;70(1):37-44. doi: 10.1080/01635581.2018.1397711.
  • Kahn JM, Davis BS, Yabes JG, Chang CH, Chong DH, Hershey TB, Martsolf GR, Angus DC. Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults With Sepsis. JAMA. 2019 Jul 16;322(3):240-250. doi: 10.1001/jama.2019.9021.
  • Akbaş T, Şenocak E, Yılmaztepe H, Sönmez F, Kös MD, Öneç B. Severe Acidemia, Leukocytosis and Low Hematocrit Levels at Admission as Mortality Predictors of Elderly Intensive Care Unit Patients. Turkish Journal of Medical & Surgical Intensive Care Medicine 2019;10(2):47−52
  • Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM, Abraham E, MacIntyre NR, Shabot MM, Duh MS, Shapiro MJ. The CRIT Study: Anemia and blood transfusion in the critically ill--current clinical practice in the United States. Crit Care Med. 2004 Jan;32(1):39-52. doi: 10.1097/01.CCM.0000104112.34142.79.
  • Manzanares W, Hardy G. Vitamin B12: the forgotten micronutrient for critical care. Curr Opin Clin Nutr Metab Care. 2010 Nov;13(6):662-8. doi: 10.1097/MCO.0b013e32833dfaec.
  • Andrès E, Serraj K, Zhu J, Vermorken AJ. The pathophysiology of elevated vitamin B12 in clinical practice. QJM. 2013 Jun;106(6):505-15. doi: 10.1093/qjmed/hct051.
  • Baker H, Leevy CB, DeAngelis B, Frank O, Baker ER. Cobalamin (vitamin B12) and holotranscobalamin changes in plasma and liver tissue in alcoholics with liver disease. J Am Coll Nutr. 1998 Jun;17(3):235-8. doi: 10.1080/07315724.1998.10718752.
  • Corcoran TB, O'Neill MP, Webb SA, Ho KM. Inflammation, vitamin deficiencies and organ failure in critically ill patients. Anaesth Intensive Care. 2009 Sep;37(5):740-7. doi: 10.1177/0310057X0903700510.
Year 2024, Volume: 4 Issue: 3, 64 - 70, 29.07.2024
https://doi.org/10.56016/dahudermj.1494846

Abstract

References

  • Dharmarajan TS, Adiga GU, Norkus EP. Vitamin B12 deficiency. Recognizing subtle symptoms in older adults. Geriatrics. 2003 Mar;58(3):30-4, 37-8.
  • Murray K, Rodwell V, Bender D, Botham KM, Weil PA, Kennelly P J. Harper's illustrated biochemistry. 28. Citeseer, New York, United States. The McGraw-Hill Companies 2009
  • Puntambekar P, Basha MM, Zak IT, Madhavan R. Rare sensory and autonomic disturbances associated with vitamin B12 deficiency. J Neurol Sci. 2009 Dec 15;287(1-2):285-7. doi: 10.1016/j.jns.2009.07.030. Epub 2009 Aug 31.
  • Smith AD, Refsum H. Vitamin B-12 and cognition in the elderly. Am J Clin Nutr. 2009 Feb;89(2):707S-11S. doi: 10.3945/ajcn.2008.26947D. Epub 2008 Dec 30.
  • Ermens AA, Vlasveld LT, Lindemans J. Significance of elevated cobalamin (vitamin B12) levels in blood. Clin Biochem. 2003 Nov;36(8):585-90. doi: 10.1016/j.clinbiochem.2003.08.004.
  • Gimsing P, Hippe E. Increased concentration of transcobalamin I in a patient with metastatic carcinoma of the breast. Scand J Haematol. 1978 Sep;21(3):243-9. doi: 10.1111/j.1600-0609.1978.tb00359.x.
  • Salles N, Herrmann F, Sakbani K, Rapin CH, Sieber C. High vitamin B12 level: a strong predictor of mortality in elderly inpatients. J Am Geriatr Soc. 2005 May;53(5):917-8. doi: 10.1111/j.1532-5415.2005.53278_7.x.
  • Geissbühler P, Mermillod B, Rapin CH. Elevated serum vitamin B12 levels associated with CRP as a predictive factor of mortality in palliative care cancer patients: a prospective study over five years. J Pain Symptom Manage. 2000 Aug;20(2):93-103. doi: 10.1016/s0885-3924(00)00169-x.
  • Dou J, Xu W, Ye B, Zhang Y, Mao W. Serum vitamin B12 levels as indicators of disease severity and mortality of patients with acute-on-chronic liver failure. Clin Chim Acta. 2012 Nov 20;413(23-24):1809-12. doi: 10.1016/j.cca.2012.07.008.
  • Oh HK, Lee JY, Eo WK, Yoon SW, Han SN. Elevated Serum Vitamin B12 Levels as a Prognostic Factor for Survival Time in Metastatic Cancer Patients: A Retrospective Study. Nutr Cancer. 2018 Jan;70(1):37-44. doi: 10.1080/01635581.2018.1397711.
  • Kahn JM, Davis BS, Yabes JG, Chang CH, Chong DH, Hershey TB, Martsolf GR, Angus DC. Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults With Sepsis. JAMA. 2019 Jul 16;322(3):240-250. doi: 10.1001/jama.2019.9021.
  • Akbaş T, Şenocak E, Yılmaztepe H, Sönmez F, Kös MD, Öneç B. Severe Acidemia, Leukocytosis and Low Hematocrit Levels at Admission as Mortality Predictors of Elderly Intensive Care Unit Patients. Turkish Journal of Medical & Surgical Intensive Care Medicine 2019;10(2):47−52
  • Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM, Abraham E, MacIntyre NR, Shabot MM, Duh MS, Shapiro MJ. The CRIT Study: Anemia and blood transfusion in the critically ill--current clinical practice in the United States. Crit Care Med. 2004 Jan;32(1):39-52. doi: 10.1097/01.CCM.0000104112.34142.79.
  • Manzanares W, Hardy G. Vitamin B12: the forgotten micronutrient for critical care. Curr Opin Clin Nutr Metab Care. 2010 Nov;13(6):662-8. doi: 10.1097/MCO.0b013e32833dfaec.
  • Andrès E, Serraj K, Zhu J, Vermorken AJ. The pathophysiology of elevated vitamin B12 in clinical practice. QJM. 2013 Jun;106(6):505-15. doi: 10.1093/qjmed/hct051.
  • Baker H, Leevy CB, DeAngelis B, Frank O, Baker ER. Cobalamin (vitamin B12) and holotranscobalamin changes in plasma and liver tissue in alcoholics with liver disease. J Am Coll Nutr. 1998 Jun;17(3):235-8. doi: 10.1080/07315724.1998.10718752.
  • Corcoran TB, O'Neill MP, Webb SA, Ho KM. Inflammation, vitamin deficiencies and organ failure in critically ill patients. Anaesth Intensive Care. 2009 Sep;37(5):740-7. doi: 10.1177/0310057X0903700510.
There are 17 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Articles
Authors

Betül Çavuşoğlu 0000-0002-8041-1904

Kübra Solmaz 0000-0003-3229-3744

Fatih Türker 0000-0002-8281-0319

Esra Ataoğlu 0000-0002-6559-2575

Publication Date July 29, 2024
Submission Date June 3, 2024
Acceptance Date June 12, 2024
Published in Issue Year 2024 Volume: 4 Issue: 3

Cite

EndNote Çavuşoğlu B, Solmaz K, Türker F, Ataoğlu E (July 1, 2024) An Independent Predictor of Mortality in Hospitalized Patients: Vitamin B12. DAHUDER Medical Journal 4 3 64–70.



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