3.5 X higher risk of death 2 years after hip fracture surgery if low vitamin D – Jan 2020

Sub-optimal serum 25-hydroxyvitamin D level affects 2-year survival after hip fracture surgery

Journal of Bone and Mineral Metabolism . https://doi.org/10.1007/s00774-019-01082-0
Eric Wei Liang Cher • John Carson Allen • Ing How Moo1 • Ean Chung Lo1 • Bryan Peh1 • Tet Sen Howe1 • Joyce Suang Bee Koh1

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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.