High prevalence and seasonal variation of hypovitaminosis D in patients scheduled for lower extremity total joint arthroplasty.
Ann Transl Med. 2018 Aug;6(16):321. doi: 10.21037/atm.2018.08.21.
Piuzzi NS1,2, George J1, Khlopas A1, Klika AK1, Mont MA1,3, Muschler GF1, Higuera CA4.
1 Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA.
2 Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
3 Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY, USA.
4 Department of Orthopaedic Surgery, Cleveland Clinic, Weston, FL, USA.
American Society of Anesthesiologists' ASA Score ≥3 was a risk factor for vitamin D <30 ng/mL
Before hip or knee replacement surgery Cleveland Ohio(?) 2006-2016
ASA score (from the web))
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
- Fewer Complications Following Revision Hip and Knee Arthroplasty in Patients with Normal Vitamin D Levels – March 2017
- 4 fewer days in hospital after hip or knee replacement if good level of vitamin D – June 2016
- Knee surgery reduced vitamin D by 40 percent in 2 days – May 2011
- Better total hip replacement if have high vitamin D
- Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016
- Improve your health BEFORE surgery (prehabilitation) helps your recovery - 2018
- Should Improve your health AND Vitamin D BEFORE many surgeries
Download the PDF from VitaminDWiki
BACKGROUND:
High rates of vitamin D insufficiency and deficiency have been demonstrated in various patient populations, including patients undergoing total joint arthroplasties (TJA). However, the risk factors associated with this condition and its seasonal variation is still to be determined in patients scheduled for elective TJA.
METHODS:
We retrospectively identified 226 (116 hips, 120 knees) patients who underwent primary TJA, and had a vitamin D measurement, at a single institution (latitude, 41° 30' N) from 2006 to 2016. Demographics, comorbidities, and perioperative data were collected from electronic medical records. Patients were stratified into vitamin D sufficient (≥30 ng/mL), insufficient (<30 ng/mL), and deficient group (<20 ng/mL). Multivariate regression analyses were used to study the risk factors for vitamin D insufficiency and deficiency.
RESULTS:
There were 99/226 (43.8%) patients in the vitamin D sufficient group, 137/226 patients (60.6%) in the insufficient group, of which 61/226 (26.9%) were in the deficient group. On multivariate analysis, an American Society of Anesthesiologists' (ASA) score ≥3 was a risk factor for vitamin D insufficiency (P<0.001), while ASA ≥3 (P<0.001) and younger age (P=0.002) were risk factors for vitamin D deficiency. Vitamin D levels varied between the quarters with lowest level seen in quarter 1 (P=0.015).
CONCLUSIONS:
There was an overall high prevalence of vitamin D insufficiency (60%) and deficiency (27%). Due to higher risk of hypovitaminosis D, particular attention should be placed in patients with an ASA score ≥3, and patients scheduled during winter season.
Conclusion from PDF
Patients scheduled for lower extremity TJA in a region of the United States, whose latitude is 41° 30' N, have an overall high prevalence of vitamin D insufficiency (60%) and deficiency (27%). Based on our findings, due to higher risk of hypovitaminosis D, particular attention should be placed in patients with an ASA score ≥3, and scheduled during winter season. Further research is needed to establish the definitive prevalence of hypovitaminosis D and the potential detrimental effect it could have on patient outcomes following TJA. Furthermore, cost-benefit analysis must determine if universal screening or treatment should be included in TJA preoperative guidelines. In summary, although we were able to identify several risk factors associated with low vitamin D insufficiency and deficiency, the effect of these conditions on patient outcomes following TJA remains to be determined, as there is a paucity of studies demonstrating causal relationship between low vitamin D levels and poor patient outcomes.
| 6071 visitors, last modified 19 Oct, 2022, |