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Fink A, Puchwein P, Fahrleitner-Pammer A, Eder-Halbedl M, Bernhardt GA. Increased Early Postoperative Complication Rate after Osteoporotic Hip Fracture in Patients with Low 25 (OH) Vitamin D Levels. Nutrients 2024; 16:1917. [PMID: 38931272 PMCID: PMC11206968 DOI: 10.3390/nu16121917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024] Open
Abstract
This study investigated the association of preoperative 25-hydroxy (25 (OH)) vitamin D levels with postoperative complications in osteoporotic hip fracture patients following surgery. We hypothesized that patients with low concentrations of 25 (OH) vitamin D might have an increased risk of developing adverse outcomes. Between January 2019 and December 2020, a retrospective observational study was conducted, including low-energy fragility fractures at the proximal femur. Regarding preoperative 25 (OH) vitamin D levels, patients were divided into two groups (<30 ng/mL and ≥30 ng/mL). Early and late postoperative complications were assessed and graded according to the Clavien-Dindo classification system. Logistic regression analysis was performed to demonstrate the association between preoperative 25 (OH) vitamin D levels (<30 ng/mL, ≥30 ng/mL) and postoperative complications after adjusting for age and sex. Of 314 patients, 222 patients (70.7%) had a 25 (OH) vitamin D level of <30 ng/mL. The mean serum 25 (OH) vitamin D level was 22.6 ng/mL (SD 13.2). In 116 patients (36.9%), postoperative complications were observed, with the most occurring in the short term (95 patients, 30.2%). Late postoperative complications were present in 21 patients (6.7%), most graded as Clavien I (57.1%). Logistic regression analysis identified a low vitamin D level (<30 ng/mL) as an independent risk factor for early postoperative complications (OR 2.06, 95% CI 1.14-3.73, p = 0.016), while no significant correlation was found in late complications (OR 1.08, 95% CI 0.40-2.95, p = 0.879). In conclusion, preoperative 25 (OH) vitamin D serum level might be an independent predictor for early postoperative complications. However, future studies are warranted to determine risk factors for long-term complications and establish appropriate intervention strategies.
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Affiliation(s)
- Andrea Fink
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria;
| | - Paul Puchwein
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria;
| | | | - Michael Eder-Halbedl
- Department of Orthopedics and Traumatology, LKH Feldbach-Fürstenfeld, Ottokar-Kernstock-Straße 18, 8330 Feldbach, Austria
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Llombart R, Mariscal G, Barrios C, de la Rubia Ortí JE, Llombart-Ais R. Impact of vitamin D deficiency on mortality in patients with hip fracture: A meta-analysis. J Am Geriatr Soc 2024; 72:268-279. [PMID: 37772615 DOI: 10.1111/jgs.18601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Vitamin D deficiency has been linked to numerous health issues, including an increased risk of hip fractures. This meta-analysis aimed to investigate the relationship between vitamin D deficiency and mortality in patients with hip fracture. To assess the impact of different levels of vitamin D deficiency on mortality in patients with hip fractures and examine the influence of potential confounding factors. METHODS A systematic search of PubMed, EMBASE, Scopus, and Cochrane Collaboration Library was conducted, resulting in nine eligible cohort studies (n = 4409). Patients with hip fractures were categorized based on their vitamin D levels as severe, moderate, or insufficient. Mortality was the primary outcome measure in this study. Subgroup analyses were performed according to the follow-up time. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model in Review Manager 5.4. RESULTS Nine studies, with a pool of 4409 patients, were included. Vitamin D insufficiency was significantly associated with increased mortality (OR 1.24, 95% CI 1.05-1.46; I2 = 4%). Severe deficiency also led to a significant increase in mortality (OR 2.08, 95% CI 1.09-3.97; I2 = 42%), whereas moderate deficiency did not show a significant effect (OR 1.06, 95% CI 0.79-1.44; I2 = 0%). Subgroup analysis revealed significant associations between vitamin D insufficiency and increased mortality at 1-year (OR 1.37, 95% CI 1.06-1.77) and 2-year follow-ups (OR 1.78, 95% CI 1.01-3.15). After adjusting for potential confounders, no significant increase in the mortality rate was observed. CONCLUSIONS This meta-analysis suggests that vitamin D insufficiency and severe deficiency are associated with increased mortality in patients with hip fracture. However, after adjusting for confounding factors, this association was not statistically significant. Further research is necessary to understand the role of vitamin D deficiency in this population.
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Affiliation(s)
- Rafael Llombart
- Orthopedic Surgery Department, University Clinic of Navarra, Pamplona, Spain
| | - Gonzalo Mariscal
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain
| | - Carlos Barrios
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain
| | | | - Rafael Llombart-Ais
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain
- Traumacenter Valencia, La Salud Hospital, Valencia, Spain
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Guerra MTE, Wagner M, Vargas A, Galia CR. Low serum levels of vitamin D significantly increase the risk of death in older adults with hip fractures: a prospective cohort. Rev Col Bras Cir 2022; 49:e20223054. [PMID: 35384992 PMCID: PMC10578824 DOI: 10.1590/0100-6991e-20223054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/25/2021] [Indexed: 11/22/2022] Open
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.
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Affiliation(s)
- Marcelo Teodoro Ezequiel Guerra
- - Universidade Luterana do Brasil - Canoas - RS - Brasil
- - Universidade Federal do Rio Grande do Sul - Porto Alegre - RS - Brasil
| | - Mario Wagner
- - Universidade Federal do Rio Grande do Sul - Porto Alegre - RS - Brasil
| | - Alfonso Vargas
- - Universidade Luterana do Brasil - Canoas - RS - Brasil
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Nurmi-Lüthje I, Tiihonen R, Paattiniemi EL, Sarkkinen H, Naboulsi H, Pigg S, Kaukonen JP, Kataja M, Lüthje P. 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. Osteoporos Int 2022; 33:611-621. [PMID: 34591132 PMCID: PMC8481108 DOI: 10.1007/s00198-021-06094-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/05/2021] [Indexed: 10/25/2022]
Abstract
UNLABELLED 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.
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Affiliation(s)
- I Nurmi-Lüthje
- Department of Public Health, Helsinki University, Mannerheimintie 172, FI-00300, Helsinki, Finland.
| | - R Tiihonen
- Department of Orthopedics and Traumatology, Päijät-Häme Central Hospital, Keskussairaalankatu 7, FI-15850, Lahti, Finland
| | - E-L Paattiniemi
- Centre for Laboratory Services, Päijät-Häme Social and Health Care Group, Keskussairaalankatu 7, FI-15850, Lahti, Finland
| | - H Sarkkinen
- Centre for Laboratory Services, Päijät-Häme Social and Health Care Group, Keskussairaalankatu 7, FI-15850, Lahti, Finland
| | - H Naboulsi
- Joint Authority for Päijät-Häme Social and Health Care Services, Päijät-Häme Social and Health Care Group, Keskussairaalankatu 7, FI-15850, Lahti, Finland
| | - S Pigg
- Kouvola Health Center, Marjoniementie 10, FI-45100, Kouvola, Finland
| | - J-P Kaukonen
- Terveystalo Lahti, Aleksanterinkatu 11-13, FI-15110, Lahti, Finland
| | - M Kataja
- National Institute for Health and Welfare, Mannerheimintie 166, FI-0027, Helsinki, Finland
| | - P Lüthje
- North Kymi Hospital, FI-45750, Kuusankoski, Finland
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Dauny V, Thietart S, Cohen-Bittan J, Riou B, Khiami F, Meziere A, Verny M, Boddaert J, Zerah L, Villain C. Association between Vitamin D Deficiency and Prognosis after Hip Fracture Surgery in Older Patients in a Dedicated Orthogeriatric Care Pathway. J Nutr Health Aging 2022; 26:324-331. [PMID: 35450987 DOI: 10.1007/s12603-022-1762-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Vitamin D deficiency is common in patients undergoing hip fracture surgery (HFS) and has been found to be associated with poor post-operative outcome in other settings. This study aimed to analyze the association between vitamin D status and prognosis after HFS. DESIGN Observational, prospective, single-center study. SETTING AND PARTICIPANTS All patients admitted in a peri-operative geriatric unit between 2009 and 2020 for HFS were included. MEASUREMENTS A moderate vitamin D deficiency was defined by a vitamin D level between 25 and 75 nmol/l and a severe deficiency by a vitamin D level <25 nmol/l. Primary endpoint was mortality 6 months after surgery. Secondary endpoints were bacterial infections and delirium during hospitalization. Odds ratio (OR) and 95% confidence interval (95%CI) were computed using logistic regression models with adjustment for confounders. RESULTS 1197 patients were included (median age 87 years, IQR [82-91]). Median vitamin D level was 55 nmol/l (IQR [30-75 nmol/l]). Moderate and severe vitamin D deficiencies were reported in 53% and 21% of patients, respectively. There was no significant association between moderate or severe vitamin D deficiencies and 6-month mortality (OR 0.91, 95%CI [0.59-1.39], and OR 1.31, 95%CI [0.77-2.22], respectively), bacterial infection (OR 0.89, 95%CI [0.60-1.31] and OR 1.55, 95%CI [0.99-2.41], respectively), nor delirium (OR 1.03, 95%CI [0.75-1.40], and OR 1.05, 95%CI [0.70-1.57], respectively). CONCLUSION Vitamin D deficiency was not associated with mortality, bacterial infection or delirium after HFS. Our results suggest that comorbidities, functional status and post-operative complications are the main determinants of post-operative outcome after HFS.
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Affiliation(s)
- V Dauny
- Cédric Villain, MD, PhD, Department of Geriatrics, CHU Caen Normandie, Caen, France, Avenue de la Côte de Nacre, 14000 Caen, France, E-mail:
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Sim DS, Tay K, Howe TS, Koh SBJ. 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. Osteoporos Int 2021; 32:2217-2224. [PMID: 33959793 DOI: 10.1007/s00198-021-05970-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
UNLABELLED Hip fractures are common in the elderly, and many patients with hip fractures have low vitamin D levels. This study found that severe vitamin D deficiency is linked to poorer recovery of function and quality of life after hip fracture surgery. INTRODUCTION Vitamin D deficiency is prevalent in hip fracture patients and associated with increased mortality and complications. However, there is limited long-term data on how vitamin D levels affect functional outcomes after hip fracture surgery. The aim of this study is to ascertain the association between vitamin D levels and recovery from hip surgery. METHODS Patients who underwent hip fracture surgery from January 2012 to December 2016 and had vitamin D levels assessed during admission were included. Retrospective analysis was performed on patients' demographic data such as age, gender and clinical parameters such as preoperative vitamin D, haemoglobin levels, Charlson Comorbidity Index (CCI), and type and site of surgery. Patients were divided according to four different vitamin D levels-severe vitamin D deficiency (≤10 ng/mL), mild deficiency (10-20 ng/ml), insufficiency (20-30 ng/ml), and normal (>30ng/ml). Functional outcomes were measured by Harris Hip Score (HHS), Parker Mobility Score (PMS), and individual domains of 36-Item Short Form Health Survey (SF36). Univariate and multivariate analyses were conducted to examine the association between vitamin D deficiency and functional outcome scores. RESULTS Out of 664 patients identified, 9% had severe vitamin D deficiency and 39% mild deficiency. Patients with severe vitamin D deficiency had significantly poorer baseline and 6-month PMS and SF36 Physical Functioning (PF). In multivariate analysis, severe vitamin D deficiency was associated with lower 6-month PMS and SF36 PF. CONCLUSION Preoperative severe vitamin D deficiency is an independent risk factor for poorer recovery of function and quality of life after hip fracture surgery.
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Affiliation(s)
- D S Sim
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
| | - K Tay
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - T S Howe
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - S B J Koh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
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Andersen CU, Strandhave C, Thaarup M, Poulsen MB, Andersen S, Olesen AE. Elderly patients with hip fracture and subnormal renal function have inadequate response to vitamin D supplementation. PHARMANUTRITION 2021. [DOI: 10.1016/j.phanu.2021.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kim HS, Jang G, Park JW, Lee YK, Koo KH. Vitamin D Deficiency and Sarcopenia in Hip Fracture Patients. J Bone Metab 2021; 28:79-83. [PMID: 33730786 PMCID: PMC7973399 DOI: 10.11005/jbm.2021.28.1.79] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/21/2020] [Indexed: 11/11/2022] Open
Abstract
Background Vitamin D plays a critical role in the proliferation and differentiation of skeletal muscle and bone metabolism. We compared the prevalence of vitamin D deficiency in elderly patients undergoing hip fracture surgery (HFS) with those undergoing elective primary total hip arthroplasty (THA). We also evaluated the association between vitamin D deficiency and sarcopenia. Methods This prospective study included 70 patients in the HFS group, and 100 patients in the elective THA group. The HFS group included 42 women, while the elective THA group included 74 women. The mean age in the HFS and elective THA groups was 79.8 and 75.4 years, respectively, and the mean preoperative Koval score was 2.1 and 2.3, respectively. Serum 25-hydroxy-vitamin D3 levels were measured by I125 radioimmunoassay. Bone mineral density and appendicular skeletal muscle mass (ASM) were measured using dual X-ray absorptiometry. Sarcopenia index was calculated by dividing ASM (kg) by the body mass index (kg/m2). Sarcopenia was diagnosed when the sarcopenia index was <0.789 in men and <0.512 in women. Results Serum vitamin D levels were lower, and the percentages of patients with vitamin D insufficiency and deficiency were higher in the HFS group than in the elective THA group. In the HFS group, the prevalence of sarcopenia was higher in men (57%, 16/28) than in women (29%, 12/42; P=0.025). Conclusions Vitamin D deficiency was more prevalent in patients undergoing HFS than in patients undergoing elective THA. Among patients undergoing HFS, vitamin D deficiency was more prevalent in sarcopenic than in non-sarcopenic patients.
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Affiliation(s)
- Hong Seok Kim
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Geun Jang
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jung Wee Park
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Han J, Cho Y, Jee S, Jo S. Vitamin D Levels in Patients with Low-energy Hip Fractures. Hip Pelvis 2020; 32:192-198. [PMID: 33335867 PMCID: PMC7724022 DOI: 10.5371/hp.2020.32.4.192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/08/2020] [Accepted: 09/18/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate serum 25(OH) vitamin D levels in patients with low-energy hip fractures. Materials and Methods Among 983 patients who underwent hip fracture surgery between August 2013 and March 2019, 732 patients were evaluated. The remaining patients were excluded due to the presence of one or more of the following: metastatic bone tumor, metabolic bone disease other than osteoporosis, fracture due to high-energy injury, atypical femoral fracture, and no blood test. We collected patient's data about age, sex male female, date of injury, a place of residence, fracture type, preinjury ambulation ability according to their Koval score, and their serum level of 25(OH) vitamin D. The mean age was 79.3 years (60-104 years). The sample was comprised of 530 female and 202 male, of which 342 had femoral neck fractures and 390 had trochanteric fractures. Results Of the total 732 patients, 346 patients (47.3%) had a 25(OH) vitamin D level of less than 10 ng/mL, 264 patients (36.1%) had scores of 10-19.9 ng/mL, 87 patients (11.9%) had scores of 20-29.9 ng/mL, and 35 patients (4.8%) had a level higher than 30 ng/mL. Vitamin D deficiency (less than 20 ng/mL) was present in 610 patients (83.3%), insufficiency (20-29.9 ng/mL) was found in 87 patients (11.9%), and 35 patients (4.8%) had normal vitamin D levels. The differences in vitamin D concentration based on season and fracture type were statistically significant. Conclusion Vitamin D deficiency and inadequacy were high in patients with low-energy hip fractures, with only 4.9% of patients had normal vitamin D levels. These findings suggest that efforts should be made to maintain proper vitamin D concentration.
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Affiliation(s)
- Jaehwi Han
- Department of Orthopaedic Surgery, Daegu Fatima Hospital, Daegu, Korea
| | - Youngho Cho
- Department of Orthopaedic Surgery, Daegu Fatima Hospital, Daegu, Korea
| | - Seungmin Jee
- Department of Orthopaedic Surgery, Daegu Fatima Hospital, Daegu, Korea
| | - Seongwoo Jo
- Department of Orthopaedic Surgery, Daegu Fatima Hospital, Daegu, Korea
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Cher EWL, Allen JC, Moo IH, Lo EC, Peh B, Howe TS, Koh JSB. Sub-optimal serum 25-hydroxyvitamin D level affects 2-year survival after hip fracture surgery. J Bone Miner Metab 2020; 38:555-562. [PMID: 31974676 DOI: 10.1007/s00774-019-01082-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/26/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Hypovitaminosis D is a common condition seen in patients with acute hip fracture. We hypothesize that in addition to the other prognosticating factors, hypovitaminosis D may affect survival in patients treated for hip fractures. The objective of this study is to evaluate the impact of serum level of 25-hydroxyvitamin D (25(OH)D) on the survivability after surgical fixation of hip fractures. MATERIALS AND METHODS We retrospectively studied data collected from January 2013 through December 2015 at a large tertiary hospital in Singapore. Patient's age, gender, Charlson Comorbidity Index (CCI), delay of surgery, fracture patterns, ASA score, as well as their pre-operative serum levels of 25(OH)D, albumin and calcium were examined. Univariate and multivariate logistic regression were used to analyse post-operative outcomes including short (inpatient, 30 and 90 days) and long-term mortality (2 years). RESULTS Data from 1004 patients were used. Information on the serum level of 25(OH)D was available in 80% of them (n = 801) and more than 90% (n = 735) of the patients had a baseline serum level of less than 30 ng/ml. Mortality rate within this group were 1.1% (n = 9) at 30 days, 1.9% (n = 15) at 90 days and 11.0% (n = 88) at 2 years follow up. Hypovitaminosis D was not a significant risk predictor for short-term mortality, but found to be a significant predictor at 2 years. CONCLUSIONS In this study, we showed a high prevalence of hypovitaminosis D among the osteoporotic hip fracture population and its impact on 2-year survivorship after hip fracture surgery.
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Affiliation(s)
- Eric Wei Liang Cher
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
| | - John Carson Allen
- Centre of Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Ing How Moo
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Ean Chung Lo
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Bryan Peh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Tet Sen Howe
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Joyce Suang Bee Koh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
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Monthly Oral Ibandronate Reduces Bone Loss in Korean Women With Rheumatoid Arthritis and Osteopenia Receiving Long-term Glucocorticoids: A 48-week Double-blinded Randomized Placebo-controlled Investigator-initiated Trial. Clin Ther 2017; 39:268-278.e2. [DOI: 10.1016/j.clinthera.2017.01.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 12/17/2016] [Accepted: 01/08/2017] [Indexed: 01/25/2023]
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