Vitamin D deficiency in hip fracture patients associated with increased mortality: study

Written by Dr Supreeth D R Published On 2024-12-23T20:30:23+05:30 | Updated On 23 Dec 2024 8:30 PM IST

Vitamin D deficiency in hip fracture patients associated with increased mortality: study

John M. Bayram et al conducted a study to assess whether vitamin D deficiency influenced mortality risk and length of acute hospital stay in patients presenting with a hip fracture. The study was conducted at Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, UK.

Vitamin D deficiency is defined by the Endocrine Society Task Force as a serum 25-hydroxyvitamin D [25(OH)D] level < 50 nmol/l.

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.

Key findings of the study were:

• 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.

The authors opined – “In conclusion, there was an independent association between vitamin D deficiency and increased mortality in hip fracture patients. These results agree with the wider literature, but the independence from confounders may be due to lack of inclusion of a comprehensive measure of comorbidity in this study. The role of routinely measuring vitamin D status in this population is debated. While some consider it mandatory, others, like the Scottish Hip Fracture Audit (SHFA), consider vitamin D deficiency so prevalent that measurement is unnecessary and treat all hip fracture patients for vitamin D deficiency. Ensuring hip fracture patients receive vitamin D supplementation during their hospital stay remains important given its high prevalence and the increased mortality, falls and fracture risks linked to vitamin D deficiency.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.