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Before and after hip fracture, vitamin D deficiency may not be treated sufficiently


Maier, S; Sidelnikov, E; Dawson-Hughes, B; Egli, A; Theiler, R; Platz, A; Staehelin, H B; Simmen, H P; Meier, C; Dick, W; Grob, D; von Eckardstein, A; Bischoff-Ferrari, H A (2013). Before and after hip fracture, vitamin D deficiency may not be treated sufficiently. Osteoporosis International, 24(11):2765-2773.

Abstract

Our findings show that only about 20 % of seniors receive vitamin D supplementation prior to their index hip fracture or after the event. We further confirm the high prevalence of severe vitamin D deficiency in this population and show that those who receive supplementation have significantly higher 25-hydroxyvitamin D (25(OH)D) status. INTRODUCTION: The aim of this study is to assess current practice in pre- and post-hip fracture care practice with respect to vitamin D supplementation. METHODS: We surveyed 1,090 acute hip fracture patients age 65 and older admitted to acute care for hip fracture repair; 844 had serum 25-hydroxyvitamin D levels measured upon admission to acute care, and 362 agreed to be followed at 12 month after their hip fracture. Prevalence of vitamin D supplementation was assessed upon admission to acute care (at the time of hip fracture), upon discharge from acute care, and at 6 and 12 months follow-up. RESULTS: Of 1,090 acute hip fracture patients (mean age 85 years, 78 % women, 59 % community-dwelling), 19 % had received any dose of vitamin D prior to the index hip fracture, 27 % (of 854 assessed) at discharge from acute care, 22 % (of 321 assessed) at 6 month, and 21 % (of 285 assessed) at 12 month after their hip fracture. At the time of fracture, 45 % had 25(OH)D levels below 10 ng/ml, 81 % had levels below 20 ng/ml, and 96 % had levels below 30 ng/ml. Notably, 25(OH)D levels did not differ by season or gender but were significantly higher among 164 hip fracture patients, with any vitamin D supplementation compared with 680 without supplementation (19.9 versus 10.8 ng/ml; p < 0.0001). CONCLUSION: Only about 20 % of seniors receive vitamin D at the time of their fracture and after the event. This is despite the documented 81 % prevalence of vitamin D deficiency. Interdisciplinary efforts may be warranted to improve vitamin D supplementation in seniors both before a hip fracture occurs and after.

Abstract

Our findings show that only about 20 % of seniors receive vitamin D supplementation prior to their index hip fracture or after the event. We further confirm the high prevalence of severe vitamin D deficiency in this population and show that those who receive supplementation have significantly higher 25-hydroxyvitamin D (25(OH)D) status. INTRODUCTION: The aim of this study is to assess current practice in pre- and post-hip fracture care practice with respect to vitamin D supplementation. METHODS: We surveyed 1,090 acute hip fracture patients age 65 and older admitted to acute care for hip fracture repair; 844 had serum 25-hydroxyvitamin D levels measured upon admission to acute care, and 362 agreed to be followed at 12 month after their hip fracture. Prevalence of vitamin D supplementation was assessed upon admission to acute care (at the time of hip fracture), upon discharge from acute care, and at 6 and 12 months follow-up. RESULTS: Of 1,090 acute hip fracture patients (mean age 85 years, 78 % women, 59 % community-dwelling), 19 % had received any dose of vitamin D prior to the index hip fracture, 27 % (of 854 assessed) at discharge from acute care, 22 % (of 321 assessed) at 6 month, and 21 % (of 285 assessed) at 12 month after their hip fracture. At the time of fracture, 45 % had 25(OH)D levels below 10 ng/ml, 81 % had levels below 20 ng/ml, and 96 % had levels below 30 ng/ml. Notably, 25(OH)D levels did not differ by season or gender but were significantly higher among 164 hip fracture patients, with any vitamin D supplementation compared with 680 without supplementation (19.9 versus 10.8 ng/ml; p < 0.0001). CONCLUSION: Only about 20 % of seniors receive vitamin D at the time of their fracture and after the event. This is despite the documented 81 % prevalence of vitamin D deficiency. Interdisciplinary efforts may be warranted to improve vitamin D supplementation in seniors both before a hip fracture occurs and after.

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9 citations in Web of Science®
16 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Geriatric Medicine
Dewey Decimal Classification:360 Social problems & social services
610 Medicine & health
300 Social sciences, sociology & anthropology
540 Chemistry
Language:English
Date:2013
Deposited On:18 Oct 2013 11:50
Last Modified:07 Dec 2017 22:56
Publisher:Springer
ISSN:0937-941X
Publisher DOI:https://doi.org/10.1007/s00198-013-2400-z
PubMed ID:23716038

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