Low serum levels of vitamin D significantly increase the risk of death in older adults with hip fractures: a prospective cohort

Abstract

Objective: to evaluate the relationship between 25(OH)D3 levels and fatal outcome in patients over 60 years of age undergoing surgical repair of hip fractures. Methods: prospective cohort of patients undergoing surgical repair of hip fractures. At admission, 25(OH)D3 levels were measured, among other parameters. Patients were followed for at least 1 year, and incident mortality was recorded. Results: 209 patients were included in the study, with a mean age of 79.5 ± 7.6 years among survivors and 80.7 ± 8.2 years among those who died in the first postoperative year (p=0.346). The 25(OH)D3 levels of survivors were significantly higher than those of patients who died (p=0.003). After adjusting for confounding variables, 25(OH)D3 levels below 12.5ng/mL were significant risk factors regardless of mortality (adjusted OR: 7.6; 95% CI: 2.35 to 24.56). Conclusions: our data show that serum 25(OH)D3 levels below 12.5ng/mL significantly and independently increased the risk of mortality in the first year after surgical repair of low-energy hip fracture in patients over 60 years of age in the geographic region where this study was conducted. Low albumin also showed a significant association with mortality in these patients. All other factors had no significant associations.

Impact of vitamin D deficiency on mortality in patients with hip fracture: A meta‐analysis

“…No relevant unpublished studies have been published to date. Ultimately, a total of nine studies were included in the meta‐analysis 7,15–22 …”

Vitamin D Deficiency in Patients With Low-Energy Hip Fractures in Accordance With the Mediterranean Paradox

“…The effect of VDD on morbidity and postoperative quality of life in patients with a hip fracture has also been assessed. It has been reported that Vitamin D inadequacy can lead to high morbidity and disability after hip fracture surgery [27,[45][46][47]. More specifically, Hao et al revealed that patients with preoperative serum vitamin D levels below 12 ng/mL presented lower walking rates at 30 and 60 days after surgery than those with higher vitamin D concentrations [45].…”

“…Likewise, LeBoff et al found that decreased vitamin D levels at the time of the fracture were associated with poor lower extremity task performance and a high risk of falls one year after a hip fracture [27]. Guerra et al underlined an even worse outcome of VDD, demonstrating that circulating levels below 12.5 ng/mL were correlated with an increased mortality rate of elderly patients after hip fracture surgical treatment within the first postoperative year [47].…”

Older adults and vitamin D hip fracture connections-what is the 2022 research base indicating?

“…However, it seems reasonable to suggest that some forms of hip fracture in older populations that are often not treated for possible osteoporotic risk 24 may derive some independent or collective benefit from vitamin D supplementation as far as reducing hip fracture incidence rates as well as mortality rates or further fractures post hip fracture surgery in vulnerable older adults. [24][25][26][27][28] In combination with silicon a recent basic study has revealed some degree of vitamin D influence on bone structure restoration and improved calcium absorption that appears to offer a possible avenue for enhancing bone related regeneration and that may prove valuable to examine further in the realm of hip fracture prevention and that is supported by human clinical evidence, [29][30][31][32] even though its presence may not impact number of falls or injurious falls that often lead to hip fractures. 33 However, there are multiple contrary study findings as well as multiple design problems that remain in this body of research, even though more favorable potentially relevant clinical findings prevail than not.…”