Vitamin D needed to prevent and treat hip fracture, but only 20 percent got any – May 2013

Before and after hip fracture, vitamin D deficiency may not be treated sufficiently.

Osteoporos Int. 2013 May 29.
Maier S, Sidelnikov E, Dawson-Hughes B, Egli A, Theiler R, Platz A, Staehelin HB, Simmen HP, Meier C, Dick W, Grob D, von Eckardstein A, Bischoff-Ferrari HA.
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.

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 12 month 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 12 months follow-up.

RESULTS: Of 1,090 acute hip fracture patients (mean age 85 years, 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 6 month, and 21 % (of 285 assessed) at 12 month after their hip fracture.
At the time of fracture,

• 45 % had 25(OH)D levels below 10 ng/ml,
• 81 % had levels below 20 ng/ml, and
• 96 % had levels below 30 ng/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 10.8 ng/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.

PMID: 23716038

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See also VitaminDWiki

• Overview Fractures and vitamin D
• All items in category Falls or Fractures and Vitamin D 258 items
• Hip fracture 19 percent less likely with just 4 ng higher level of vitamin D – Dec 2012
• Hip fractures greatly reduced by sunshine, vitamin D, and Vitamin K – meta-analysis Sept 2012
• Guideline following hip fracture – 50000 IU vitamin D daily for 7 days – Jan 2013
• Task force for senior fall prevention finally recommends 800 IU of vitamin D – May 2012
• Following chart was presented back in 2003