Prevalence of 25-hydroxyvitamin d deficiency in the acute inpatient rehabilitation population and its effect on function.
Arch Phys Med Rehabil. 2011 May;92(5):705-11.
Pellicane AJ, Wysocki NM, Mallinson TR, Schnitzer TJ.
Wayne State University, Rehabilitation Institute of Michigan, Detroit, MI.
OBJECTIVES: To assess the prevalence of 25-hydroxyvitamin D (25OHD) insufficiency and deficiency in the acute inpatient rehabilitation setting, identify risk factors associated with low serum 25(OH)D levels, and assess whether hypovitaminosis D affects the function of rehabilitation patients.
DESIGN: Retrospective cohort study.
SETTING: Academic acute rehabilitation facility.
PARTICIPANTS: Patients (N=101) admitted for acute inpatient rehabilitation between September 2008 and December 2008.
INTERVENTIONS: Serum 25(OH)D levels drawn within 24 hours of admission.
MAIN OUTCOME MEASURES: 25(OH)D level, total/motor/cognitive FIM efficiency.
RESULTS: Considering patients not receiving 25(OH)D supplementation at the time of admission, 23.0% were 25(OH)D sufficient, 68.9% were insufficient, and 8.1% were deficient. Patients receiving 25(OH)D supplementation at the time of admission had significantly higher 25(OH)D levels than patients not receiving 25(OH)D supplementation (33.4±12.8 vs 23.7±11.4ng/mL; P=.001). A total of 72.2% of patients with any fracture and 80.0% of patients with fracture due to fall were not receiving supplementation at the time of admission; 72.2% of patients with any fracture and 73.3% of patients with fracture due to fall were 25(OH)D insufficient. Unadjusted total FIM efficiency scores were statistically significantly different by 25(OH)D status (2.96±1.42 vs 2.29±1.41ng/mL; P=.039). However, 25(OH)D level was not a significant predictor of total FIM efficiency score after controlling for demographic and clinical factors.
CONCLUSIONS: Of acute rehabilitation patients, 77% are 25(OH)D insufficient or deficient at admission. 25(OH)D supplementation is associated with a greater 25(OH)D level in these patients; however, almost half those supplemented had 25(OH)D levels less than the reference range.
Most inpatients with fracture due to fall were transferred to acute inpatient rehabilitation without 25(OH)D supplementation despite clear guidelines indicating its use in this situation.
Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
PMID: 21530717
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See also VitaminDWiki
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- All items in category Bone - Osteoporosis 83 items Aug 2011
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- National Osteoporosis Foundation on Vitamin D - more than 30 ng - 2010
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- Upper body bones fractured along with hip when extremely low on vitamin D – Sept 2010
- Vitamin D and Fracture Prevention – June 2010 file
- Vitamin D and Calcium for the prevention of fractures
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- Hip fractures in India - editorial with recommendation Sept 2010
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- Low vitamin D may account for half of the reasons for osteomalacia – Oct 2010
- Fewer falls and fractures as vitamin D is increased – 1800 to 4000 IU July 2010
- 4X more likely to add Calcium to diet than take supplements – Sept 2010
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- Vitamin D and Calcium Absorption – Sept 2010
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- Wrist fracture is also associated with vitamin D inadequacy – Feb 2011
- National Osteoporosis Foundation on Vitamin D - more than 30 ng - 2010 800 to 1000 IU daily for elderly
- Lowest cost osteoporosis treatment was vitamin D and Calcium – Oct 2010
- Half of orthopedic surgeries had vitamin D less than 32 ng – Dec 2010
- Noticed bones heal faster when more than 60 ng of vitamin D
- suspect not just dark skin, but those also at risk of being low on vitamin D: sunlight, elderly, medical problems, etc.
- Hip surgery followed by 100,000 IU, then 1,000 IU of vitamin D daily – June 2010
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- Upper body bones fractured along with hip when extremely low on vitamin D – Sept 2010
- Low cost co-factors for vitamin D More than Calcium is needed for healthy bones
- Vitamin D and Fracture Prevention – June 2010
- Vitamin D and calcium for the prevention of fractures
- Cochrane review finds that Vitamin D helps prevent fractures– downloaded Feb 2010
- Osteoporosis reduced by 800 or more IU of vitamin D - July 2010
- 4000 IU Vitamin D intervention helped elderly bones – March 2010
- 400 IU of Vitamin D Magnesium and Calcium helped Twin bones – Feb 2011
- 400 IU is the least amount of vitamin D - wonder how low of vitamin D needed if take all of the co-factors
- Hip fractures in India - editorial with recommendation Sept 2010
- 75 percent of hip fractures associated with vitamin D deficiency - Jan 2011
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- Hip fractures worse if very low on vitamin D – Mar 2011
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