Preoperative vitamin D status and its effects on short-term clinical outcomes in lumbar spine surgery
Journal of Orthopaedic Science https://doi.org/10.1016/j.jos.2019.10.011
Hao-WeiXu1 BinShen1 TaoHuWei-Dong ZhaoDe-Sheng WuShan-Jin Wang
Trauma and surgery category starts with the following
Trauma and Surgery category hasLarge dose Vitamin D before surgery was found to help by 35 studies
Vitamin D is needed before most surgeries – many studies and RCTs
4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024
Sepsis is both prevented and treated by Vitamin D - many studies
Thyroidectomy and Vitamin D - many studies
Orthopaedic surgeries need Vitamin D – many studies
Cancer - After diagnosis chemotherapy
TBI OR "Traumatic Brain Injury - 21 in title as of Sept 2022
Superbug (Clostridium difficile) Infections strongly associated with low vitamin D - many studies
Glutamine and Omega-3 have also been proven to help several traumas/surgeries
Note: Vitamin D also prevents the need for various surgeries and Omega-3 prevents many concussions/TBI
Trauma and Surgery is associated with 22 other VitaminDWiki categories
Such as loading dose 33, Mortality 23, Infant-Child 21 Intervention 19 Cardiovascular 13, Injection 13 in Sept 2022
The items which are in both Intervention and Trauma/Surgery categories are listed here
- Spinal TB surgery now includes Vitamin D as the standard of care (5,000 IU daily) – Sept 2024
- Sepsis (with mechanical ventilation) treated by 5days of 50,000 IU of Vitamin D – RCT May 2024
- Half as much AFIB after bypass if 600,000 IU of vitamin D before surgery – RCT April 2022
- Half as many problems if take Vitamin D (300,000 IU) before thyroidectomy – RCT Jan 2021
- Those getting an injection of 300,000 IU Vitamin D got out of the ICU a week sooner – RCT Dec 2020
- Traumatic Brain Injury – 120,000 IU of Vitamin D resulted in 3 fewer days on ventilators – RCT March 2020
- Better Surgical outcomes if preceded by Vitamin D loading dose – Oct 2018
- Knee replacement not helped by 2,000 IU of vitamin D (both too late and too little) – RCT July 2018
- Heart attack ICU costs cut in half by Vitamin D – Oct 2018
- Urinary sepsis – a single Vitamin D injection reduced hospital days by 40 percent – RCT April 2018
- Ventilator-associated pneumonia death rate cut in half by Vitamin D injection (300,000 IU) – RCT July 2017
- ICU cost reduced by at least 27,000 dollars if get high dose vitamin D in first week - April 2017
- Vitamin D and Glutamine reduced Trauma Center deaths by half – Matthews March 2017
- Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016
- Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016
- 18 fewer hospital days if given 500,000 IU of vitamin D while ventilated in ICU – RCT June 2016
- ICU death rate reduced 3X when a vitamin D injection changed the PTH – Nov 2015
- Heart Attack ICU costs reduced $37,000 by $20 of Vitamin D – Nov 2015
- Vitamin D intervention increased by 20 percent the survival of critically ill patients- RCT June 2014
- Vitamin D aided progesterone in reducing traumatic brain injury – RCT Dec 2012
- Sepsis is both prevented and treated by Vitamin D - many studies
Background
Many studies have found that vitamin D deficiency has a high incidence rate worldwide, but we found few studies on the role of vitamin D in spinal degenerative diseases. We investigated the determinants of preoperative vitamin D deficiency and its effects on postoperative outcomes among patients undergoing elective lumbar spine surgery.
Methods
360 patients treated from July 2017 to July 2018 were retrospectively identified for inclusion. The patients’ fasting serum levels of 25(OH)D, N-terminal midfragment of osteocalcin (N-MID), and β typeⅠcollagen carboxyl terminal peptide (β-CTX) were measured by electrochemiluminescence before the operation. The visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) and Oswestry Disability Index scores (ODI) were used to evaluate the clinical outcomes. Standard demographic data and all perioperative complications occurring within 3 months follow-up after operation were recorded.
Results
The mean serum level of 25(OH)D was 20.81 ± 8.55 ng/mL, the rates of deficiency (<20 ng/ml) was 53.6%. The abnormal proportion of N-MID and β-CTX were 8.61% and 34.44%, bone turnover markers serum level was higher in older age groups (p < 0.05). Female sex (p < 0.001), a high body mass index (BMI) (p = 0.012), lack of vitamin D supplementation (p = 0.018), smoking (p = 0.033), moderate (p < 0.001) to severe pain (p = 0.005) were significant predictors of vitamin D deficiency after the multivariate analysis. The VAS, JOA and ODI scores showed significantly better outcomes compared to deficient group at post-operative and final follow-up (p < 0.05).
Conclusion
Vitamin D deficiency was common in patients undergoing elective lumbar spine surgery. Female sex, high BMI, lack of vitamin D supplementation, smoking and moderate to severe pain were risk factors for vitamin D deficiency. Moreover, preoperative hypovitaminosis D (<20 ng/ml) was correlated with worse surgical outcomes in short-term.
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