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Hip surgery followed by 100000 IU then 1000 IU of vitamin D daily – June 2010

Vitamin D and nutritional supplements in the revalidation of older people after hip surgery

doi:10.1016/j.eurger.2010.05.007 | How to Cite or Link Using DOI
Copyright © 2010 Elsevier Masson SAS and European Union Geriatric Medicine Society All rights reserved.
S. Detiennea, E-mail The Corresponding Author, M. VandewoudeCorresponding Author Contact Information, a, E-mail The Corresponding Author and R. Suya, E-mail The Corresponding Author
a University Department of Geriatrics, ZNA (ziekenhuisnetwerk Antwerpen) St Elisabeth, University of Antwerp, Leopoldstraat 26, 2000 Antwerp, Belgium
Received 14 April 2010; accepted 6 May 2010. Available online 7 June 2010.

Hypovitaminosis D is common in older people. Low vitamin D may contribute to hip fracture risk.

Methods During a 15-week period all people admitted for revalidation after hip surgery (elective or after fracture) were screened for hypovitaminosis D.
A standard substitution was given consisting of 100,000 IU vitamin D at day 1 followed by calcium/vit D 1000/880 once daily together with a high caloric nutritional supplement.
Vitamin D, PTH and nutritional parameters were measured at baseline and at follow-up.

Results One hundred and three patients were enrolled (78% women, mean age 82.1 ± 6.2 years) of which 82% were treated for hip fracture.
In the fracture group there is a significantly higher prevalence of osteoporosis (63.9% versus 20.0%; p ? 0.005).

Vitamin D insufficiency (< 30 ng/ml) is extremely prevalent in both groups (94.2% versus 92.8%) with levels below 15 ng/ml in respectively 35.3% and 53.0% for the elective and the fracture group. Highest values of PTH were seen in people with the lowest levels of vitamin D.

After intervention there is a significant rise in serum vitamin D (15.6–26.3 ng/ml; p ? 0.001) and a significant reduction in plasma PTH (40.2–32.1 pg/ml; p ? 0.001).

Conclusion A majority of patients after hip surgery has vitamin D deficiency. People with traumatic fracture were significantly more osteoporotic.
By implementing standard vitamin D and caloric supplementation in the revalidation after hip surgery PTH levels are significantly lowered and nutritional parameters improve.
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