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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. ; Simmen, H-P ; Meier, C. ; Dick, W. ; Grob, D. ; von Eckardstein, A. ; Bischoff-Ferrari, H.

In: Osteoporosis International, 2013, vol. 24, no. 11, p. 2765-2773

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    Titre
    • Before and after hip fracture, vitamin D deficiency may not be treated sufficiently
    Auteur
    • Maier, S.. Centre on Aging and Mobility, University of Zurich and Waid City Hospital, Department of Geriatrics and Aging Research, University Hospital Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland
    • Sidelnikov, E.. Centre on Aging and Mobility, University of Zurich and Waid City Hospital, Department of Geriatrics and Aging Research, University Hospital Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland
    • Dawson-Hughes, B.. USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
    • Egli, A.. Centre on Aging and Mobility, University of Zurich and Waid City Hospital, Department of Geriatrics and Aging Research, University Hospital Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland
    • Theiler, R.. Department of Rheumatology, City Hospital Triemli, Zurich, Switzerland
    • Platz, A.. Department of Traumatology, City Hospital Triemli, Zurich, Switzerland
    • Staehelin, H.. Department of Geriatrics, University of Basel, Basel, Switzerland
    • Simmen, H-P. Department of Traumatology, University Hospital, Zurich, Switzerland
    • Meier, C.. Department of Traumatology, City Hospital Waid, Zurich, Switzerland
    • Dick, W.. Department of Orthopedic Surgery, Basel University Hospital, Basel, Switzerland
    • Grob, D.. Department of Geriatrics, City Hospital Waid, Zurich, Switzerland
    • von Eckardstein, A.. Institute of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
    • Bischoff-Ferrari, H.. Centre on Aging and Mobility, University of Zurich and Waid City Hospital, Department of Geriatrics and Aging Research, University Hospital Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Osteoporosis International, 2013, vol. 24, no. 11, p. 2765-2773. Springer London
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:318068
    Summary
    Summary: 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 12month 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 12months follow-up. Results: Of 1,090 acute hip fracture patients (mean age 85years, 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 6month, and 21% (of 285 assessed) at 12month after their hip fracture. At the time of fracture, 45% had 25(OH)D levels below 10ng/ml, 81% had levels below 20ng/ml, and 96% had levels below 30ng/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 10.8ng/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