Vitamin D status and complications, readmissions, and mortality after hip fracture

Ingstad, Frida; Solberg, Lene Bergendal; Nordsletten, Lars; Thorsby, Per Medbøe; Hestnes, Ingvild; Frihagen, Frede

doi:10.1007/s00198-020-05739-9

Cited by 26 publications

(27 citation statements)

References 44 publications

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“…[21] Therefore, the delirium in vitamin D deficient patients may be due to increased in- flammation in brain. [19] We also found that preoperative vitamin D deficient group had a higher risk of pneumonia than preoperative vitamin D sufficient group in hip fracture patients. There have been no studies associating preoperative vitamin D deficiency and pneumonia after hip fracture surgery.…”

Section: Discussionmentioning

confidence: 51%

“…reported that 51% of hip fracture patients had delirium and the concentration of vitamin D (25[OH]D) was lower than controls in their case-control study. Ingstad et al [ 19 ] reported that 21% of the preoperative vitamin D deficient group and 15% of preoperative vitamin D sufficient group were diagnosed with delirium. The risk of delirium was significantly high in vitamin D deficient group (OR, 1.48; 95 CI, 1.04–2.12; P =0.03).…”

Section: Discussionmentioning

confidence: 99%

“…[ 21 ] Therefore, the delirium in vitamin D deficient patients may be due to increased inflammation in brain. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Vitamin D Deficiency is Associated with Postoperative Functional Recovery and Complications after Hip Fracture Surgery

et al. 2021

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Background: Low concentrations of vitamin D are considered one of the risk factors for hip fracture and are associated with worse outcomes. The purpose of this retrospective study was to compare vitamin D deficient group and vitamin D sufficient group and assess the association preoperative vitamin D deficiency and postoperative walking ability after hip fracture surgery.Methods: Between January 2014 and January 2020, 1,029 elderly patients with hip fracture (243 in men and 785 in women) were measured preoperative serum 25-hydroxy-vitamin D3 levels. Among 1,029 elderly patients, 702 patients were classified as Vitamin D deficient group (<20 ng/mL). Outcome parameters for functional recovery were the length of the hospital stay and KOVAL score, and those for complications were delirium, pneumonia, and thromboembolism.Results: The mean length of the hospital stay in the vitamin D deficient group was significantly longer than in the vitamin D sufficient group (27.7±17.8 vs. 2.9±11.8 days; odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05; P=0.001). The mean postoperative KOVAL score in the deficient group was significantly higher than in the sufficient group (4.0±2.1 vs. 3.1±1.9 days; OR, 1.21; 95% CI, 1.11-1.32; P=0.001). Vitamin D deficiency was significantly associated with a higher risk of delirium and pneumonia in deficiency group.Conclusions: Preoperative vitamin D deficiency in hip fractures patients was associated with prolonged duration of hospital stay and decrease of postoperative ambulatory status, and may increase the risk of delirium and pneumonia. Therefore, it is necessary to evaluate the preoperative vitamin D level and recommend vitamin D supplementation in elderly patients with a high probability of hip fracture.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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Preoperative Vitamin D Deficiency is Associated with Postoperative Functional Recovery and Complications after Hip Fracture Surgery

et al. 2021

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“…Low vitamin D (< 50 nmol/L) at admission for hip fracture increased the risk of delirium, new hip fracture, and medical readmission, but not surgical complications in 1122 patients at Oslo University Hospital, Norway [ 17 ]. On the other hand, persons with higher levels (≥ 75 nmol/L) who had prior falls had no benefit in lower extremity function and were associated with an increased risk of falls [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Relatively low and moderate pre-fracture serum 25-hydroxyvitamin D levels associated with the highest survival in elderly hip fracture patients in Finland: a minimum 3-year follow-up

Nurmi-Lüthje

Tiihonen

et al. 2021

Osteoporos Int

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Summary The association between serum 25-hydroxyvitamin D level and post-fracture mortality indicates beneficial relatively high serum 25-hydroxyvitamin D concentrations. A 1-year cohort study on 245 hip fracture patients in Finland indicated the lowest 3-year mortality and highest survival among patients with serum 25-hydroxyvitamin D level of 50–74 nmol/L. Purpose To explore pre-fracture serum 25-hydroxyvitamin D level as a factor associated with post-fracture survival among a cohort of hip fracture patients in Finland. Methods A prospectively collected cohort of hip fracture patients ( n = 245, 70% women) from two hospitals was followed for 3.2 post-hip fracture years. Serum 25-hydroxyvitamin D was measured in admission to the hospital and classified: < 50, 50–74, 75–99, and ≥ 100 nmol/L. Survival was analyzed with a Bayesian multivariate model. Relative survival was explored with the life table method according to serum 25-hydroxyvitamin D. Mortality according to serum 25-hydroxyvitamin D level and to the hospital was calculated. Results Mortality in the patients with serum 25-hydroxyvitamin D level of 50–74 nmol/L was significantly lower than in all other patients together at every post-fracture year. The most important factors for survival were age under 85 years; living in an actual/private home; serum 25-hydroxyvitamin D level of 50–74 nmol/L, followed by 75–99 nmol/L; ASA classes 1–2 and 3; and female sex. The mean age of patients with serum 25-hydroxyvitamin D level of 50–99 nmol/L was significantly higher than in other levels. Relative survival was highest in men, women, and patients in hospital B with serum 25-hydroxyvitamin D level of 50–74 nmol. Conclusion The highest 3-year survival and the lowest mortality in this cohort appeared in patients with pre-fracture serum 25-hydroxyvitamin D level of 50–74 nmol/L. This result differs from similar studies and is lower than the recommended level of 25-hydroxyvitamin D among hip fracture patients. The results should be examined in future research with larger data. Supplementary Information The online version contains supplementary material available at 10.1007/s00198-021-06094-z.

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“…Most of the conducted studies do not consider these types of fracture separately [ 65 ]. Apart from death, they may lead to a significant deterioration of the physical condition and loss of independence [ 66 ]. Postmenopausal women are the most significant group in HF incidents.…”

Section: Hip Fracturesmentioning

confidence: 99%

Vitamin D Supplementation and Its Impact on Different Types of Bone Fractures

et al. 2022

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Vitamin D helps to balance the levels of calcium and phosphorus to maintain proper bone structure. It is also involved in essential biological roles and displays a wide spectrum of potential benefits in the human body. Since there are many types of fractures that occur at specific ages and due to different circumstances, the influence of vitamin D on the frequency of a particular fracture may differ. Thus, the authors investigated the possible preventive effect of vitamin D on the risks of vertebral fractures, hip fractures, stress fractures and pediatric fractures. Additional aspects of vitamin D, especially on recuperation after injures and its impact on the severity of particular fractures, were also discussed. It was suggested that vitamin D supplementation may contribute to a reduction in hip fracture risk due to reduced bone turnover, decreased frequency of falls and improved muscle function. Furthermore, vitamin D appears to lower the risk of stress fractures in athletes and military recruits. Due to a nonunified protocol design, presented investigations show inconsistencies between vitamin D supplementation and a decreased risk of vertebral fractures. However, a vitamin D preventive effect on pediatric fractures seems to be implausible.

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Vitamin D status and complications, readmissions, and mortality after hip fracture

Cited by 26 publications

References 44 publications

Preoperative Vitamin D Deficiency is Associated with Postoperative Functional Recovery and Complications after Hip Fracture Surgery

Preoperative Vitamin D Deficiency is Associated with Postoperative Functional Recovery and Complications after Hip Fracture Surgery

Relatively low and moderate pre-fracture serum 25-hydroxyvitamin D levels associated with the highest survival in elderly hip fracture patients in Finland: a minimum 3-year follow-up

Vitamin D Supplementation and Its Impact on Different Types of Bone Fractures

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