Vitamin D has been shown to impact prognosis in a variety of retrospective and randomized clinical trials within an intensive care unit (ICU) environment. Despite these findings, there have been no studies examining the impact of hypovitaminosis D in specialized neurocritical care units (NCCU). Given the often significant differences in the management of patients in NCCU and more generalized intensive care units there is a need for further inquiries into the impact of low vitamin D levels in this specific environment. This study proposes a randomized, double-blinded, placebo-controlled, single center evaluation of vitamin D supplementation in the emergent NCCU patient population. The primary outcome will involve length-of-stay for emergent neurocritical care patients. Various secondary outcomes, including in-hospital mortality, ICU length-of-stay, Glasgow Outcome Score on discharge, complications and quality-of-life metrics. Patients will be followed for 6 months post-discharge.
Inclusion Criteria: * Patients \>18 years of age * Patients admitted to the neurosurgery or neurology services * Patients admitted to a critical care unit * Informed consent * Expected to stay in the ICU for 48 hours or more * Vitamin D deficiency (\<20ng/mL) Exclusion Criteria: * Patients where a vitamin D level was not drawn within 48 hours of admission * Patients not randomized within 48 hours of admission * Readmitted patients to the critical care unit * Lack of informed consent * Prior supplementation with vitamin D * Severely impaired gastrointestinal function * Other trial participation * Pregnant or lactating women * Hypercalcemia (total calcium of \>10.6 mg/dL or ionized serum calcium of \>5.4 mg/dL * Tuberculosis history or clinical exam * Sarcoidosis history or clinical exam * Nephrolithiasis within the prior year * Patients not deemed suitable for study participation (ie, psychiatric disease, living remotely from the clinic, or prisoner status) * Pregnant or nursing women