Vitamin D levels in frail elderly patients with a hip fracture

2013 ◽  
Vol 4 ◽  
pp. S63 ◽  
Author(s):  
M. Abildgaard Pedersen ◽  
M. Gregersen ◽  
B. Lomholt Langdahl ◽  
E.M. Skjøde Damsgaard
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Frail Elderly ◽  
Vitamin D Levels

scholarly journals O02 Is vitamin D testing essential in elderly patients with a hip fracture?

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Serena N Mehta ◽  
Mohd K Omar ◽  
Hem Sapkota
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Osteoporosis Treatment ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Medication History ◽  
Vitamin D Levels ◽  
High Dose Vitamin

Abstract Background Elderly patients with hip fractures are likely to be vitamin D deficient. As per some studies, a vitamin D level above 75nmol/L is considered to be sufficient for this cohort. The majority of these patients will require treatment for their osteoporosis. Prior to treatment, vitamin D levels need to be sufficient, however there is often a delay to obtain vitamin D test results and this can postpone the initiation of osteoporosis management. In this retrospective study, we hypothesised whether empirical, high dose vitamin D treatment can be given to patients with hip fractures, regardless of their vitamin D level, who are not currently on vitamin D supplementation. Methods We obtained a list of 917 patients with a hip fracture, aged over 50, from the Trust National Hip Fracture Database from January 2017 to December 2018. We accessed patients’ electronic hospital and GP records to collect patient demographics, vitamin D levels, and medication history. Results The mean age in this study was 82.7 years, and 69.8% were female. Vitamin D levels were available for 666 patients. Of this, 69.9% of patients had a below adequate level (50 nmol/L) and 88.4% of patients had a below sufficient level (75 nmol/L) of vitamin D. Electronic records for vitamin D supplementation were only available for 434 patients. Of this, 300 patients (69.1%) were not on any form of vitamin D supplementation. In this cohort, only 7 patients had a vitamin D level above sufficient levels (75 nmol/L). Upon contacting these 7 patients; 3 were taking some form of vitamin D supplementation, 3 died and no information was available for 1. Conclusion Our study demonstrates all patients with a hip fracture, who are not taking any form of vitamin D supplementation will have subtherapeutic vitamin D levels. Thus, patients presenting with a hip fracture, can be treated empirically with high dose vitamin D treatment, without prior vitamin D testing. This would reduce the number of vitamin D tests conducted by 69.1% which will enable patients to receive prompt osteoporosis treatment and will reduce costs. Disclosures S.N. Mehta None. M.K. Omar None. H. Sapkota None.

Elderly patients with trochanteric hip fracture have lower serum Vitamin D levels compared to patients with cervical hip fracture

2011 ◽  
Vol 52 (1) ◽  
pp. e15-e18 ◽  
Author(s):  
Olga E. Dretakis ◽  
Andrew N. Margioris ◽  
Christos Tsatsanis ◽  
Konstantin E. Dretakis ◽  
Niki Malliaraki ◽  
...  
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Serum Vitamin ◽  
Lower Serum ◽  
Serum Vitamin D ◽  
Vitamin D Levels

scholarly journals Vitamin D and Calcium Supplementation in Elderly Patients Suffering Fragility Fractures; The Road not Taken

2017 ◽  
Vol 11 (1) ◽  
pp. 1230-1235 ◽  
Author(s):  
Aaron K. Saini ◽  
Edward J.C. Dawe ◽  
Simon M. Thompson ◽  
John W. Rosson
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Fragility Fracture ◽  
Calcium Supplementation ◽  
Serum Vitamin ◽  
Fragility Fractures ◽  
Vitamin D Supplementation ◽  
Vitamin D Levels ◽  
Vitamin D Supplements

Background: Calcium and Vitamin D supplementation in elderly patients may decrease the risk of hip fracture by up to one-third. Many patients suffering fragility fractures do not go on to receive this treatment despite clear recommendations from the National Institute for Health and Clinical Excellence (NICE). The aim of this study was to audit the proportion of patients admitted with a hip fracture who had suffered a previous fragility fracture and were taking calcium and vitamin D supplements, with the standard being that all of these patients should have been taking bone protection. We also aimed to assess the Vitamin D levels of patients admitted with a hip fracture to our unit. Methods: Patients were prospectively added to a database over a 12-month period. Serum vitamin D levels (25-OH D3) were measured on admission and case-notes were reviewed for pre-injury social function and mobility. Results: 147 patients were included in the study. Median age was 85 years (Interquartile range 79 – 90 (Range 53 – 100 years)). Only eighteen patients (11.4%) were taking calcium and vitamin D supplementation on admission. Forty seven patients (29%) had documented evidence of a previous fragility fracture within the last seven years. Only fourteen of these patients (19%) were receiving calcium and vitamin D supplementation. One hundred and twenty two patients were deficient in Vitamin D (76%). Twenty five patients (16%) had insufficient Vitamin D. Only the remaining 14 patients (8%) had sufficient vitamin D. Conclusion: Vitamin D deficiency is endemic amongst patients suffering hip fractures. Very few patients who had suffered a previous fragility fracture were taking Calcium and Vitamin D supplements when admitted with a hip fracture several years later. This is an opportunity missed.

scholarly journals Association between preoperative evaluation with lung ultrasound and outcome in frail elderly patients undergoing orthopedic surgery for hip fractures: study protocol for an Italian multicenter observational prospective study (LUSHIP)

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Luigi Vetrugno ◽  
Enrico Boero ◽  
Elena Bignami ◽  
Andrea Cortegiani ◽  
Santi Maurizio Raineri ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Postoperative Complications ◽  
Observational Study ◽  
Elderly Patients ◽  
Fracture Fixation ◽  
Frail Elderly ◽  
Statistical Power ◽  
Lung Ultrasound ◽  
Preoperative Evaluation ◽  
Cardiac Complications

Abstract Background Hip fracture is one of the most common orthopedic causes of hospital admission in frail elderly patients. Hip fracture fixation in this class of patients is considered a high-risk procedure. Preoperative physical examination, plasma natriuretic peptide levels (BNP, Pro-BNP), and cardiovascular scoring systems (ASA-PS, RCRI, NSQIP-MICA) have all been demonstrated to underestimate the risk of postoperative complications. We designed a prospective multicenter observational study to assess whether preoperative lung ultrasound examination can predict better postoperative events thanks to the additional information they provide in the form of “indirect” and “direct” cardiac and pulmonary lung ultrasound signs. Methods LUSHIP is an Italian multicenter prospective observational study. Patients will be recruited on a nation-wide scale in the 12 participating centers. Patients aged  >  65 years undergoing spinal anesthesia for hip fracture fixation will be enrolled. A lung ultrasound score (LUS) will be generated based on the examination of six areas of each lung and ascribing to each area one of the four recognized aeration patterns—each of which is assigned a subscore of 0, 1, 2, or 3. Thus, the total score will have the potential to range from a minimum of 0 to a maximum of 36. The association between 30-day postoperative complications of cardiac and/or pulmonary origin and the overall mortality will be studied. Considering the fact that cardiac complications in patients undergoing hip surgery occur in approx. 30% of cases, to achieve 80% statistical power, we will need a sample size of 877 patients considering a relative risk of 1.5. Conclusions Lung ultrasound (LU), as a tool within the anesthesiologist’s armamentarium, is becoming increasingly widespread, and its use in the preoperative setting is also starting to become more common. Should the study demonstrate the ability of LU to predict postoperative cardiac and pulmonary complications in hip fracture patients, a randomized clinical trial will be designed with the scope of improving patient outcome. Trial registration ClinicalTrials.gov, NCT04074876. Registered on August 30, 2019.

scholarly journals The effect of vitamin-d levels on prognosis of elderly patients treated in intensive care unit

2020 ◽  
Vol 10 (1) ◽  
pp. 13-17
Author(s):  
Hülya YİĞİT ÖZAY ◽  
İbrahim MUNGAN ◽  
Güneş ÇOBANOĞLU ERCAN ◽  
Sema TURAN ◽  
Banu ELER ÇEVİK
Keyword(s):  
Intensive Care Unit ◽  
Vitamin D ◽  
Intensive Care ◽  
Elderly Patients ◽  
Vitamin D Levels

scholarly journals Vitamin D Levels and Nutritional Risk Index: Mobility and Mortality After Hip Fracture Surgery (P01-013-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lihong Hao ◽  
Yvette Schlussel ◽  
Jeffrey Carson ◽  
Sue Shapses
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Vitamin D Deficiency ◽  
Risk Index ◽  
Nutritional Risk ◽  
Walking Ability ◽  
Hip Fracture Surgery ◽  
Vitamin D Levels ◽  
Nutritional Risk Index ◽  
Fracture Surgery

Abstract Objectives Hip fractures are associated with a high rate of morbidity and mortality, and successful ambulation after surgery is an important outcome in this patient population. This study aims to determine whether 25-hydroxyvitamin D (25(OH)D) or the Geriatric Nutritional Risk Index (GNRI) is associated with short term mortality or ability to walk after hip fracture surgery. Methods Patients undergoing hip fracture repair were included in this study. Mortality and walking ability were assessed at 30 and 60 days after hip fracture surgery. Pre-operative serum albumin and 25(OH)D were measured. Patients were characterized with 25(OH)D <12 ng/mL, 12 to <20, 20 to <30 or ≥30. GNRI was calculated from albumin and body weight and patients were categorized into major/moderate nutritional risk (<92), low risk (92 to <98) or in good nutritional status (≥98). Results Of the 290 patients (82 ± 7 years, BMI 25 ± 5 kg/m2), 73% were females. Compared to patients with vitamin D deficiency (<12 ng/mL), those with vitamin D levels in higher categories had increased ability to walk at 30 days (P = 0.031): 12 to <20 ng/ml (adjusted odds ratio = 2.61; 95% confidence interval = 1.13–5.99); 20 to <30 ng/ml (3.48; 1.53–7.95); ≥30 ng/ml (2.84; 1.12–7.20). In addition, patients also had increased mobility at 60 days in these same higher vitamin D categories 12 to <20 (2.67; 1.14–6.25); 20 to <30 (3.42; 1.46–8.00); ≥30 ng/ml (3.67; 1.37–9.82) compared to the reference group (<12 ng/mL; P = 0.028). There was no association of vitamin D with mortality at either time point. GNRI was not associated with mortality or walking ability. Conclusions In patients with hip fracture, vitamin D deficiency (<12 ng/mL) was associated with reduced ambulation after surgery, whereas GNRI was not associated with any outcomes. Mechanisms that attenuate mobility due to vitamin D deficiency should be examined in future studies. Funding Sources ONE Nutrition Grant to SAS and JLC.

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