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Vitamin D Deficiency in Hip Fracture Patients is Associated with an Increased Mortality Risk

Overview
Journal Eur J Orthop Surg Traumatol
Specialty Orthopedics
Date 2024 Dec 2
PMID 39621172
Authors
John M Bayram
Hariprasath Kanesan
Nicholas D Clement
Affiliations
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Abstract

Purpose: The aims were to assess whether vitamin D deficiency influenced mortality risk and length of acute hospital stay in patients presenting with a hip fracture.

Methods: A retrospective study was undertaken including all patients aged over 50 years that were admitted with a hip fracture to a single centre during a 24-month period. Serum vitamin D levels on admission, patient demographics, perioperative variables and mortality were collected. Cox regression analysis was utilised to determine the independent association between serum vitamin D levels and patient mortality.

Results: The cohort consisted of 1510 patients with a mean age of 81.3 years and 1107 (71.4%) were female. 876 (58.0%) were vitamin D deficient (< 50 nmol/l). The median follow up was 405 (IQR 249 to 610) days. During follow-up there were 464 deaths (30.7%). Vitamin D deficiency was independently associated with higher mortality risk (hazard ratio [HR] 1.26, 95% confidence interval (CI) 1.03 to 1.53, P = 0.022). Male sex (HR 1.64, 95% CI 1.34 to 2.01, P < 0.001) was also associated with a higher mortality risk. Vitamin D deficiency was not associated with length of hospital stay (median difference 0 days, P = 0.207).

Conclusion: Vitamin D deficiency was independently associated with increased mortality in hip fracture patients, though this finding may be influenced by lack of comprehensive adjustment for comorbidity. While the value of routine serum vitamin D measurement is debated, supplementation during hospital stays is important to reduce falls and fracture risks associated with deficiency.

References
1.
Bischoff-Ferrari H, Willett W, Wong J, Giovannucci E, Dietrich T, Dawson-Hughes B . Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005; 293(18):2257-64. DOI: 10.1001/jama.293.18.2257. View
2.
Trevisan C, Bedogni M, Pavan S, Shehu E, Piazzani F, Manzato E . The impact of second hip fracture on rehospitalization and mortality in older adults. Arch Gerontol Geriatr. 2020; 90:104175. DOI: 10.1016/j.archger.2020.104175. View
3.
Huotari A, Herzig K . Vitamin D and living in northern latitudes--an endemic risk area for vitamin D deficiency. Int J Circumpolar Health. 2008; 67(2-3):164-78. DOI: 10.3402/ijch.v67i2-3.18258. View
4.
Dauny V, Thietart S, Cohen-Bittan J, Riou B, Khiami F, Meziere A . 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(4):324-331. DOI: 10.1007/s12603-022-1762-3. View
5.
Fu G, Wu R, Zhang R, Chen D, Li H, Zheng Q . Preoperative Vitamin D Deficiency is Associated with Increased One-Year Mortality in Chinese Geriatric Hip Fracture Patients - A Propensity Score Matching Study. Clin Interv Aging. 2023; 18:263-272. PMC: 9945644. DOI: 10.2147/CIA.S395228. View