Preoperative severe vitamin D deficiency is a significant independent risk factor for poorer functional outcome and quality of life 6 months after surgery for fragility hip fractures

Sim, David Shaoen; Tay, Kiang-Hiong; Howe, Tet Sen; Koh, Suang Bee

doi:10.1007/s00198-021-05970-y

Cited by 9 publications

(10 citation statements)

References 22 publications

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“…Since the Charlson Comorbidity Index (CCI) was proposed, an increasing number of studies have shown that it has a significant correlation with the mortality, prognosis and curative effect [ 19 , 20 , 21 ]. However, the application of the CCI is still limited in the field of spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, the application of the CCI is still limited in the field of spinal surgery. Sim DS [ 21 ] divided the patients into two groups by the CCI (CCI 0–1 and CCI ≥ 2) and found that the CCI was an independent risk factor for the Parker mobility score after hip fracture surgery. Similarly, we also adopted this grouping, but we did not find a correlation between the CCI and the prognosis of patients with DCM.…”

Section: Discussionmentioning

confidence: 99%

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The Pre-Operative Duration of Symptoms: The Most Important Predictor of Post-Operative Efficacy in Patients with Degenerative Cervical Myelopathy

Guo

Lin

et al. 2022

Brain Sciences

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Objective. To explore the most important predictors of post-operative efficacy in patients with degenerative cervical myelopathy (DCM). Methods. From January 2013 to January 2019, 284 patients with DCM were enrolled. They were categorized based on the different surgical methods used: single anterior cervical decompression and fusion (ACDF) (n = 80), double ACDF (n = 56), three ACDF (n = 13), anterior cervical corpectomy and fusion (ACCF) (n = 63), anterior cervical hybrid decompression and fusion (ACHDF) (n = 25), laminoplasty (n = 38) and laminectomy and fusion (n = 9). The follow-up time was 2 years. The patients were divided into two groups based on the mJOA recovery rate at the last follow-up: Group A (the excellent improvement group, mJOA recovery rate >50%, n = 213) and Group B (the poor improvement group, mJOA recovery rate ≤50%, n = 71). The evaluated data included age, gender, BMI, duration of symptoms (months), smoking, drinking, number of lesion segments, surgical methods, surgical time, blood loss, the Charlson Comorbidity Index (CCI), CCI classification, imaging parameters (CL, T1S, C2-7SVA, CL (F), T1S (F), C2-7SVA (F), CL (E), T1S (E), C2-7SVA (E), CL (ROM), T1S (ROM) and C2-7SVA (ROM)), maximum spinal cord compression (MSCC), maximum canal compromise (MCC), Transverse area (TA), Transverse area ratio (TAR), compression ratio (CR) and the Coefficient compression ratio (CCR). The visual analog score (VAS), neck disability index (NDI), modified Japanese Orthopedic Association (mJOA) and mJOA recovery rate were used to assess cervical spinal function and quality of life. Results. We found that there was no significant difference in the baseline data among the different surgical groups and that there were only significant differences in the number of lesion segments, C2–7SVA, T1S (F), T1S (ROM), TA, CR, surgical time and blood loss. Therefore, there was comparability of the post-operative recovery among the different surgical groups, and we found that there were significant differences in age, the duration of symptoms, CL and pre-mJOA between Group A and Group B. A binary logistic regression analysis showed that the duration of the symptoms was an independent risk factor for post-operative efficacy in patients with DCM. Meanwhile, when the duration of symptoms was ≥6.5 months, the prognosis of patients was more likely to be poor, and the probability of a poor prognosis increased by 0.196 times for each additional month of symptom duration (p < 0.001, OR = 1.196). Conclusion. For patients with DCM (regardless of the number of lesion segments and the proposed surgical methods), the duration of symptoms was an independent risk factor for the post-operative efficacy. When the duration of symptoms was ≥6.5 months, the prognosis of patients was more likely to be poor, and the probability of a poor prognosis increased by 0.196 times for each additional month of symptom duration (p < 0.001, OR = 1.196).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Pre-Operative Duration of Symptoms: The Most Important Predictor of Post-Operative Efficacy in Patients with Degenerative Cervical Myelopathy

Guo

Lin

et al. 2022

Brain Sciences

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“…One study focused on the effect of low vitamin D levels before surgery on functional recovery six months following surgery. They used Harris Hip Score (HHS), Parker Mobility Score (PMS), and 36-Short Form Health Survey (SF36) to assess functional recovery and to evaluate mobility after hip fracture surgery [ 6 ]. The result showed that patients with extremely low vitamin D levels demonstrated lower scores of PMS and SF36 PF.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study done in Saudi Arabia suggests that the incidence of hip fractures, with an approximated number of hip fractures in people over the age of 50 years, was around 2949 in 2015 and is expected to increase nearly seven-fold to 20,328 by 2050 [ 4 ]. A population of one billion worldwide have vitamin D deficiency [ 5 ], and it is certainly a prominent risk factor for increased mortality and hip fracture-related complications [ 6 ]. In 2016, Falcker et al suggested that about 87% of the patients with hip fractures had vitamin D deficiency, further implying that in patients with vitamin D deficiency, the mortality would be increased [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Time Until Full Weight Bearing After Hip Fractures and Vitamin D Levels in Patients Aged 50 Years and Above

Altuwairqi

Tammar

et al. 2022

Cureus

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Introduction Hip fractures are common in the elderly, especially with vitamin D deficiency. Currently, there is a paucity of case-control studies regarding the relationship between the time until full weight bearing of hip fractures and vitamin D levels in Saudi Arabia. Our aim is to determine time until full weight bearing of hip fractures in patients with vitamin D deficiency compared with normal vitamin D in the age of 50 and above. Materials and methods This was a hospital-based non-interventional retrospective case-control study conducted among patients with hip fractures aged 50 years and above between January 2017 and April 2021. It was done at King Abdulaziz university hospital, Jeddah, Saudi Arabia. A review of the medical records and operation records for the relative operation was done to check patients' lab values around the time of the operation and following the documented healing process. Data were analyzed using SPSS version 26 (IBM Inc., Armonk, New York). Correlation analysis was performed using Spearman's test, and a p-value of 0.05 was considered statistically significant. Results In our research, 36 patients were participants in the study, with about two-thirds (22) of the participants being female (61.1%). 52.8% of the participants had an age ranging from 71-80 years, with a mean age of 75.66 ± 9.53 years. A non-significant relationship between the time until full weight bearing of hip fractures and the vitamin d levels is demonstrated. By that, the research question was disproved by the given data. Conclusion The time until full weight bearing of hip fracture is not significantly related to vitamin D level. In this study, the majority of patients (77.1%) were vitamin D deficient, which raises our concern for vitamin D deficiency to be a major health problem in our society. However, this evidence should be further assessed in larger trials. Additional studies on this topic are recommended to be done.

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“…15 Another 2021 report found preoperative severe vitamin D deficiency to be a significant independent risk factor for poorer functional outcome and quality of life 6 months after surgery for fragility hip fractures. 16 This was not surprising given that hip fractures are common in the elderly, and many of these patients may well have low vitamin D levels. This may be an important generalizable finding to some degree that indicates a possible need to routinely evaluate vitamin D levels among those older adults, especially those with any presiding severe vitamin D deficiency, and to do all that is possible to prevent a poorer recovery process than desirable 16 and where up to 9% may have a severe vitamin D deficiency and 39%, a mild deficiency.…”

Section: Specific Observationsmentioning

confidence: 99%

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

Marks¹

2022

MOJGG

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Preoperative severe vitamin D deficiency is a significant independent risk factor for poorer functional outcome and quality of life 6 months after surgery for fragility hip fractures

Cited by 9 publications

References 22 publications

The Pre-Operative Duration of Symptoms: The Most Important Predictor of Post-Operative Efficacy in Patients with Degenerative Cervical Myelopathy

The Pre-Operative Duration of Symptoms: The Most Important Predictor of Post-Operative Efficacy in Patients with Degenerative Cervical Myelopathy

The Relationship Between Time Until Full Weight Bearing After Hip Fractures and Vitamin D Levels in Patients Aged 50 Years and Above

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

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