High Rates of Vitamin D Deficiency in Acute Rehabilitation Patients

Abstract

Objective To determine the prevalence of low vitamin D (<30 ng/mL), including vitamin D insufficiency (20-29.9 ng/mL) and deficiency (<20 ng/mL), in an acute rehabilitation setting. Design Cross-sectional, retrospective cohort study. Setting University-affiliated inpatient rehabilitation facility (IRF) at a metropolitan county hospital. Participants Patients (N=100; 64 men/36 women), aged 19-92 years (mean, 62±18.9y), who were admitted to and discharged from an IRF over a 6-month study period. The most frequent admitting diagnoses included stroke (n=11), brain injury (n=36), spinal cord injury (n=14), and polytrauma (n=10). Interventions Not applicable. Main Outcome Measures Serum vitamin-25 (OH)D level at admission to the IRF. Results Of 100 patients, 76% had low vitamin D (<30 ng/mL), with 29% demonstrating vitamin D insufficiency (20-29.9 ng/mL) and 47% demonstrating vitamin D deficiency (<20 ng/mL). Younger patients demonstrated higher rates of vitamin D deficiency compared with older patients ( P <.0001). Conclusions Low vitamin D is common in patients admitted to the IRF, with rates more than double those reported in the general population among individuals younger than 45 years. The current results suggest that the IRF setting may be a favorable checkpoint to screen for and initiate treatment of low vitamin D and optimize rehabilitation outcomes.

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“…A recent study found low (<30 ng/mL) vitamin D levels in 76% of patients in an inpatient rehabilitation facility, with diagnoses including neurologic injury and polytrauma [58]. Vitamin D and its active metabolite (1,25-dihydroxycholecalciferol) calcitriol are well documented to increase calcium and phosphate absorption in the gastrointestinal tract, increase calcium reabsorption by the kidney, and both have osteoblastogenic and osteoclastogenic effects on bone [59].…”