BACKGROUND: Substantial proportions of hip-fracture patients have very low serum levels of 25-hydroxyvitamin D, which can negatively affect rehabilitation. However, it is not known whether changes in vitamin D deficiency have occurred over the last years in the patients who sustain hip fractures. AIM: To assess time trend 2000-2013 of calcifediol serum levels in the hip-fracture patients admitted to our rehabilitation division. DESIGN: Retrospective observational study. METHODS: We evaluated 1599 inpatients with a hip fracture admitted between January 1, 2000 and December 31, 2013 to our rehabilitation division. A blood sample was collected in the morning following an overnight fasting 14.4 ± 4.4 (mean ± SD) days after surgery. We assessed 25-hydroxyvitamin D levels by an immunoenzymatic assay. RESULTS: Calcifediol levels increased till 2006-2007 and decreased afterward. In 2006-2007, the median 25-hydroxyvitamin D level (13.1 ng/ml, interquartile range 7.9-25ng/ml) was significantly higher (p<0.001) than the one found in both the periods 2000-2001 (5.4 ng/ml, interquartile range 3.5-9 ng/ml), and 2012-2013 (7ng/ml, interquartile range 5-14 ng/ml). In the last two-year period of observation (2012-2013), 25-hydroxyvitamin D levels were slightly higher (p<0.001) than in the first one (2000-2001). The association between periods of observation and 25-hydroxyvitamin D levels persisted after adjustment for age, BMI, and sex (p<0.001). CONCLUSIONS: A significant increase in calcifediol concentrations was seen till 2006-2007, but a significant decrease was observed afterward. Finally, calcifediol levels were only slightly higher in the last two years of observation than in the first two years and severe vitamin D deficiency was common during the whole 14-year study period. CLINICAL REHABILITATION IMPACT: Heightened awareness is needed to prevent and treat vitamin D deficiency in hip-fracture patients.
Time trend 2000-2013 of vitamin D status in older people who sustain hip fractures: steps forward or steps back? A retrospective study of 1599 inpatients
DI MONACO, ROBERTO;
2015-01-01
Abstract
BACKGROUND: Substantial proportions of hip-fracture patients have very low serum levels of 25-hydroxyvitamin D, which can negatively affect rehabilitation. However, it is not known whether changes in vitamin D deficiency have occurred over the last years in the patients who sustain hip fractures. AIM: To assess time trend 2000-2013 of calcifediol serum levels in the hip-fracture patients admitted to our rehabilitation division. DESIGN: Retrospective observational study. METHODS: We evaluated 1599 inpatients with a hip fracture admitted between January 1, 2000 and December 31, 2013 to our rehabilitation division. A blood sample was collected in the morning following an overnight fasting 14.4 ± 4.4 (mean ± SD) days after surgery. We assessed 25-hydroxyvitamin D levels by an immunoenzymatic assay. RESULTS: Calcifediol levels increased till 2006-2007 and decreased afterward. In 2006-2007, the median 25-hydroxyvitamin D level (13.1 ng/ml, interquartile range 7.9-25ng/ml) was significantly higher (p<0.001) than the one found in both the periods 2000-2001 (5.4 ng/ml, interquartile range 3.5-9 ng/ml), and 2012-2013 (7ng/ml, interquartile range 5-14 ng/ml). In the last two-year period of observation (2012-2013), 25-hydroxyvitamin D levels were slightly higher (p<0.001) than in the first one (2000-2001). The association between periods of observation and 25-hydroxyvitamin D levels persisted after adjustment for age, BMI, and sex (p<0.001). CONCLUSIONS: A significant increase in calcifediol concentrations was seen till 2006-2007, but a significant decrease was observed afterward. Finally, calcifediol levels were only slightly higher in the last two years of observation than in the first two years and severe vitamin D deficiency was common during the whole 14-year study period. CLINICAL REHABILITATION IMPACT: Heightened awareness is needed to prevent and treat vitamin D deficiency in hip-fracture patients.
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