Vitamin D and Healthcare Service Utilization in Children: Insights from a Machine Learning Approach
Vitamin D deficiency and insufficiency is a global health issue: an association has been demonstrated between vitamin D deficiency and a myriad of acute and chronic illnesses. Data regarding vitamin D status among children hospitalized with non-critical illnesses are scanty. We aimed to: (1) identif...
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MDPI AG
2022-12-01
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Series: | Journal of Clinical Medicine |
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Online Access: | https://www.mdpi.com/2077-0383/11/23/7157 |
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author | Giuliana Ferrante Salvatore Fasola Michele Piazza Laura Tenero Marco Zaffanello Stefania La Grutta Giorgio Piacentini |
author_facet | Giuliana Ferrante Salvatore Fasola Michele Piazza Laura Tenero Marco Zaffanello Stefania La Grutta Giorgio Piacentini |
author_sort | Giuliana Ferrante |
collection | DOAJ |
description | Vitamin D deficiency and insufficiency is a global health issue: an association has been demonstrated between vitamin D deficiency and a myriad of acute and chronic illnesses. Data regarding vitamin D status among children hospitalized with non-critical illnesses are scanty. We aimed to: (1) identify profiles of children hospitalized due to non-critical illnesses, using vitamin D levels as the driving outcome; (2) assess the association between patient profiles and length of stay. The study included 854 patients (1–17 years old) who underwent blood tests for detecting vitamin D levels. A regression tree was used to stratify patients. The relationship between vitamin D levels and length of stay was explored using Poisson regression. The regression tree identified three subgroups. Group A (16%): African, North African, Hispanic, and Indian patients. Group B (62%): Caucasian and Asian patients hospitalized for respiratory, metabolic, ill-defined, infective, and genitourinary diseases. Group C (22%): Caucasian and Asian patients hospitalized for digestive, nervous, and musculoskeletal diseases, blood and skin diseases, and injuries. Mean serum vitamin D level (ng/mL) was 13.7 (SD = 9.4) in Group A, 20.5 (10.0) in Group B, and 26.2 (12.6) in Group C. Group B was associated with the highest BMI z-score (<i>p</i> < 0.001) and the highest frequency of preterm births (<i>p</i> = 0.041). Mean length of stay was longer in Group A than in the other groups (<i>p</i> < 0.001) and decreased significantly by 9.8% (<i>p</i> = 0.024) in Group A and by 5% (<i>p</i> = 0.029) in Group B per 10 ng/mL increase in vitamin D level. We identified three subgroups of hospitalized children, defined according to ethnicity and discharge diagnosis, and characterized by increasing vitamin D levels. Vitamin D levels were associated with length of hospitalization. |
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language | English |
last_indexed | 2024-03-09T17:43:17Z |
publishDate | 2022-12-01 |
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series | Journal of Clinical Medicine |
spelling | doaj.art-23b14421be234820967dcbfee21cac7d2023-11-24T11:23:52ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-011123715710.3390/jcm11237157Vitamin D and Healthcare Service Utilization in Children: Insights from a Machine Learning ApproachGiuliana Ferrante0Salvatore Fasola1Michele Piazza2Laura Tenero3Marco Zaffanello4Stefania La Grutta5Giorgio Piacentini6Department of Surgery, Dentistry, Pediatrics and Gynaecology, Pediatric Division, University of Verona, 37134 Verona, ItalyInstitute of Translational Pharmacology, National Research Council, 90146 Palermo, ItalyDepartment of Surgery, Dentistry, Pediatrics and Gynaecology, Pediatric Division, University of Verona, 37134 Verona, ItalyAOUI Verona—Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, 37126 Verona, ItalyDepartment of Surgery, Dentistry, Pediatrics and Gynaecology, Pediatric Division, University of Verona, 37134 Verona, ItalyInstitute of Translational Pharmacology, National Research Council, 90146 Palermo, ItalyDepartment of Surgery, Dentistry, Pediatrics and Gynaecology, Pediatric Division, University of Verona, 37134 Verona, ItalyVitamin D deficiency and insufficiency is a global health issue: an association has been demonstrated between vitamin D deficiency and a myriad of acute and chronic illnesses. Data regarding vitamin D status among children hospitalized with non-critical illnesses are scanty. We aimed to: (1) identify profiles of children hospitalized due to non-critical illnesses, using vitamin D levels as the driving outcome; (2) assess the association between patient profiles and length of stay. The study included 854 patients (1–17 years old) who underwent blood tests for detecting vitamin D levels. A regression tree was used to stratify patients. The relationship between vitamin D levels and length of stay was explored using Poisson regression. The regression tree identified three subgroups. Group A (16%): African, North African, Hispanic, and Indian patients. Group B (62%): Caucasian and Asian patients hospitalized for respiratory, metabolic, ill-defined, infective, and genitourinary diseases. Group C (22%): Caucasian and Asian patients hospitalized for digestive, nervous, and musculoskeletal diseases, blood and skin diseases, and injuries. Mean serum vitamin D level (ng/mL) was 13.7 (SD = 9.4) in Group A, 20.5 (10.0) in Group B, and 26.2 (12.6) in Group C. Group B was associated with the highest BMI z-score (<i>p</i> < 0.001) and the highest frequency of preterm births (<i>p</i> = 0.041). Mean length of stay was longer in Group A than in the other groups (<i>p</i> < 0.001) and decreased significantly by 9.8% (<i>p</i> = 0.024) in Group A and by 5% (<i>p</i> = 0.029) in Group B per 10 ng/mL increase in vitamin D level. We identified three subgroups of hospitalized children, defined according to ethnicity and discharge diagnosis, and characterized by increasing vitamin D levels. Vitamin D levels were associated with length of hospitalization.https://www.mdpi.com/2077-0383/11/23/715725(OH)Dvitamin D deficiencypaediatricshospitalizationregression treeinternational classification of diseases |
spellingShingle | Giuliana Ferrante Salvatore Fasola Michele Piazza Laura Tenero Marco Zaffanello Stefania La Grutta Giorgio Piacentini Vitamin D and Healthcare Service Utilization in Children: Insights from a Machine Learning Approach Journal of Clinical Medicine 25(OH)D vitamin D deficiency paediatrics hospitalization regression tree international classification of diseases |
title | Vitamin D and Healthcare Service Utilization in Children: Insights from a Machine Learning Approach |
title_full | Vitamin D and Healthcare Service Utilization in Children: Insights from a Machine Learning Approach |
title_fullStr | Vitamin D and Healthcare Service Utilization in Children: Insights from a Machine Learning Approach |
title_full_unstemmed | Vitamin D and Healthcare Service Utilization in Children: Insights from a Machine Learning Approach |
title_short | Vitamin D and Healthcare Service Utilization in Children: Insights from a Machine Learning Approach |
title_sort | vitamin d and healthcare service utilization in children insights from a machine learning approach |
topic | 25(OH)D vitamin D deficiency paediatrics hospitalization regression tree international classification of diseases |
url | https://www.mdpi.com/2077-0383/11/23/7157 |
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