P258: Are vitamin D levels associated with clinical outcomes in acute hip fracture patients?

2014 ◽  
Vol 5 ◽  
pp. S165-S166
Author(s):  
D. Ariza ◽  
J.I. González-Montalvo
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Clinical Outcomes ◽  
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.

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

The relationship between serum vitamin D levels and breast cancer prognosis: A meta-analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1521-1521
Author(s):  
April Ann Nicole Rose ◽  
Christine Elser ◽  
Pamela Jean Goodwin
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Vitamin D ◽  
Clinical Outcomes ◽  
Survival Data ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Vitamin D Levels ◽  
The Relationship

1521 Background: Vitamin D (VitD) is a circulating hormone known to regulate gene transcription in breast cancer (BC) cells. The association between VitD and BC risk has been extensively studied. Until recently, however, the role of VitD in BC progression and its association with clinical outcomes among BC patients was poorly understood. To assess these new developments, a systematic review and meta-analysis was performed. Methods: A systematic review and meta-analysis by searching MEDLINE (1982 – 2012), ASCO, and SABCS for abstracts (2009 – 2012), with the following keywords: “breast cancer” and “prognosis” or “survival”, and “vitamin D” or ”calcitriol.” Abstracts were scrutinized for reports correlating serum VitD levels with breast cancer clinical outcomes, including: disease-free survival (DFS) and overall survival (OS). Studies were included if serum VitD samples were taken shortly after diagnosis and survival data were reported. Meta-analyses were performed using an inverse-variance weighted fixed-effects model. Results: We identified 7 studies reporting correlative data between serum VitD levels and BC survival. These data included 4,885 patients evaluated for DFS and 3858 patients evaluated for OS. VitD-deficiency was defined as <30ng/mL, <20ng/mL, and <14ng/mL in 3, 3, and 1 studies, respectively, and was identified in an average of 48.1% of patients (range: 17.9-87.8%). VitD deficiency was associated with a pooled hazard ratio (HR) of 2.13 (CI: 1.64 - 2.78) and 1.76 (CI: 1.35 - 2.30) for DFS and OS, respectively. Conclusions: To our knowledge, this is the first report of a meta-analysis of the relationship between serum VitD and BC prognosis. The prevalence of VitD-deficiency varied widely across studies and may reflect differences in geographic location, race, and rates of supplementation across patient populations. These findings support the hypothesis that VitD-deficient breast cancer patients have poorer clinical outcomes than VitD sufficient patients; but do not establish whether this relationship is causative. Further studies are warranted to investigate the possible protective effects of VitD supplementation on survival among VitD-deficient BC patients.

scholarly journals Bone biopsies and serum vitamin-D levels in patients with hip fracture

1989 ◽  
Vol 60 (4) ◽  
pp. 411-413 ◽  
Author(s):  
Itamar Eventov ◽  
Bertha Frisch ◽  
Doron Alk ◽  
Zipora Eisenberg ◽  
Yosef Weisman
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Serum Vitamin ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Bone Biopsies

VIRTUAL ORTHOPEDIC-REHABILITATION-METABOLIC COLLABORATION FOR TREATING OSTEOPOROTIC HIP FRACTURES

2020 ◽  
Vol 26 (3) ◽  
pp. 332-339 ◽  
Author(s):  
Osnat Tell Lebanon ◽  
Doron Netzer ◽  
Eyal Yaacobi ◽  
Yitshal Berner ◽  
Devorah Spiegel ◽  
...  
Keyword(s):  
Primary Care ◽  
Vitamin D ◽  
Hip Fracture ◽  
Intervention Group ◽  
Osteoporosis Treatment ◽  
Health Maintenance ◽  
Post Surgery ◽  
Vitamin D Levels ◽  
Orthopedic Rehabilitation ◽  
Clinic Visits

Objective: To evaluate the effectiveness of a virtual, closed-loop protocol that treated hip fracture patients without formal clinic visits. Methods: In this prospective cohort study, an intervention group of 85 hip fracture patients (33.6%) with vitamin D levels ≥65 nmol/L who received recommendations for osteoporosis treatment, was compared to a nonintervention group of 168 (66.4%), with vitamin D <65 nmol/L. Treatment included vitamin D loading in orthopedic and rehabilitation departments for patients from both groups, and virtual, osteoporosis treatment recommendations by Metabolic Clinic physicians to patients from the intervention group upon achieving a vitamin D level ≥65 nmol/L. Recommendations were given without requiring clinic visits. Osteoporosis drug recommendations were relayed to primary care physicians. The primary endpoint was patients receiving osteoporosis drugs within 12-months post-surgery. Secondary endpoints were patients issued drugs within 3- and 6-months post-surgery, and 1-year post-fracture mortality rates. Results: Among 253 hip fracture patients (81.3 ± 10.7 years-of-age, 68.8% women), the postintervention osteoporosis medication issue rate was higher than in the nonintervention group (48.2% versus 22.0%, respectively; P<.001). More intervention group patients received drugs 3 months (18.8% versus 2.9%; P<.001) and 6 months after surgery (40% versus 5.9%; P<.001). One-year mortality was lower among patients who received any osteoporosis medications (either through our intervention or from community physicians) than among untreated patients (5.1% versus 26.3%; P<.001). Conclusion: Virtual orthopedic-rehabilitation-metabolic collaboration increased osteoporosis treatment rates post-hip fracture. Yet, treatment rates remained <50%. Additional research is required to increase treatment rates further, such as providing drug therapy shortly after surgery, perhaps during rehabilitation, or lowering the vita-min D threshold. Abbreviations: CHS = Clalit Health Services; FLS = Fracture liaison service; HMO = Health Maintenance Organization; MMC = Meir Medical Center; PCP = primary care physician

Perioperative vitamin D levels correlate with clinical outcomes after ankle fracture fixation

2015 ◽  
Vol 136 (3) ◽  
pp. 339-344 ◽  
Author(s):  
Stephen J. Warner ◽  
Matthew R. Garner ◽  
Joseph T. Nguyen ◽  
Dean G. Lorich
Keyword(s):  
Vitamin D ◽  
Clinical Outcomes ◽  
Fracture Fixation ◽  
Ankle Fracture ◽  
Vitamin D Levels

scholarly journals Coronavirus in HIP Fractures CHIP 2: Is Vitamin D Deficiency Associated with Increased Mortality from COVID-19 Infections in A Hip Fracture Population?

2021 ◽  
Vol 3 (6) ◽  
pp. 111-116
Author(s):  
A. Mahmood ◽  
F. Rashid ◽  
D. Hawkes ◽  
W. J. Harrison
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Primary Outcome Measure ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Fracture Population ◽  
The Impact ◽  
The Relationship

Purpose: There is controversy as to whether vitamin D deficiency is associated with increased mortality from coronavirus infection. The aim of the study was to assess the relationship between vitamin D levels and 30-day mortality in hip fracture patients co-infected with COVID-19. Methods: This was a national observational audit conducted between 23 March 2020 (start of UK lockdown) and 31st December 2020. The cohort consisted of patients aged >60 years presenting with a hip fracture. Patients were included if they had a vitamin D level done during the admission episode, diagnosis of COVID-19 infection via a viral reverse transcriptase PCR swab, and a hip fracture. There were 517 patients included in the study from 43 different hospital trusts. The primary outcome measure was 30-day mortality. Secondary outcomes were the percentage of patients who had vitamin D deficiency, the percentage of patients who were prescribed Vitamin D, and the impact of vitamin D prescribing on mortality Results: Vitamin D deficiency was not associated with a higher 30-day mortality. Low serum vitamin D was observed in 56% of the patients on admission. Vitamin D was prescribed prior to admission in 28% and during admission in a further 49%. Pre-hospital vitamin D therapy reduced the chance of vitamin D deficiency. Starting vitamin D before or on admission did not affect the mortality rates. Conclusion: Vitamin D deficiency was common, but not associated with a higher 30-day mortality in the hip fracture population co-infected with COVID-19.

scholarly journals Lack of association between vitamin D insufficiency and clinical outcomes of patients with COVID-19 infection 

2020 ◽  
Author(s):  
Alireza Davoudi ◽  
Narges Najafi ◽  
Mohsen arabi ◽  
Atefe Tayebi ◽  
Roja Nikaeen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Clinical Outcomes ◽  
Underlying Disease ◽  
Vitamin D Insufficiency ◽  
Mazandaran Province ◽  
Vitamin D Levels ◽  
Duration Of Hospitalization ◽  
North Of Iran ◽  
Definition Of ◽  
Sufficient Vitamin

Abstract Background A protective effect of vitamin D against COVID-19 is under investigation. We aimed to analyze the effect of vitamin D sufficiency on clinical outcomes of patients with COVID-19 infection. Methods In this retrospective study we analyzed the vitamin D levels of COVID-19 patients who were admitted to Razi Hospital (an infectious disease referral center in Mazandaran province in north of Iran) from February to March 2020. Overall, a cutoff point of 30 ng/mL was used for the definition of vitamin D sufficiency. Results 153 patients were analyzed in this study who had laboratory documentation of a 25(OH) D level at the time of hospitalization. In total, 62.7% (n-=96) of the patients had a 25(OH) D level of less than 30 ng/mL and 37.25% (n = 57) had a 25(OH) D level of more than 30 ng/mL. In total, 49% (n = 75) of the patients suffered from at least one underlying disease. Vitamin D sufficiency was not associated with a statistically significant lower risk of adverse clinical outcomes of COVID-19 such as duration of hospitalization, lung involvement, intensive care unit (ICU) admission, invasive and non-invasive ventilation, the severity of disease or death. Conclusions Sufficient vitamin D levels were not found to be protective against adverse clinical outcomes in patients infected with COVID-19.

scholarly journals Implications of Vitamin D Levels in COVID-19 Morbidity and Mortality

2020 ◽  
pp. 2-3
Author(s):  
Seyedeh Niki Sadat Afjeh ◽  
Nahal Emami Fard ◽  
Paniz Poursharif
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
Clinical Outcomes ◽  
Vitamin D Insufficiency ◽  
T Regulatory Cell ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Randomized Controlled Studies ◽  
Vitamin D Levels ◽  
One Year

Vitamin D is a steroid hormone known for maintaining bone health. Vitamin D deficiency is a 25-hydroxyvitamin D (25(OH)D) serum concentration below 25 nmol/L. In contrast, vitamin D insufficiency occurs at levels below 75 nmol/L. Vitamin D insufficiency and deficiency affect 70% and 30% of the US population, respectively. Emerging evidence associates optimal vitamin D levels with better clinical outcomes in COVID-19. This literature review analyzed three preliminary articles that explored associations between vitamin D levels, COVID-19 mortality, and risk of adverse clinical outcomes in adult hospitalized patients. Google Scholar was used to find studies that diagnosed COVID-19 with reverse transcription (RT-PCR). In a cross-sectional analysis, Maghbooli et al. (2020) reported that vitamin D sufficient patients had a significantly lower chance (9.7%, n=77, p=0.01) of severe COVID-19 complications than deficient patients (32.8%, n=158, p=0.01). This study is under review for diagnosis accuracy and sample size. A retrospective cohort study by Raharusun et al. (2020), which included active and expired cases (n=780), found that 98.9% (p<0.001) of vitamin D deficient COVID-19 patients and 88% (p<0.001) with insufficiency died, but only 4% of sufficient individuals died. Lastly, a retroactive cohort study by Meltzer et al. (2020) reported higher rates of COVID-19 infection, 21.6% (95% CI, 14.0-29.2%), in vitamin D deficient groups (n=172), compared to 12.2% (95% CI, 8.5-15.4%) in sufficient groups (n=327). The 25(OH)D levels were measured within one year of COVID-19 testing. All studies controlled for age, sex, and comorbidities, while the first controlled for BMI and smoking, and the third controlled for race. Vitamin D sufficiency may activate the innate and adaptive immune systems, leading to an antiviral response. Receptor binding of vitamin D on neutrophils and macrophages stimulates cathelicidin expression, an antibacterial peptide. Macrophage and T-regulatory cell quantities also increase. These results reveal the need for randomized controlled studies of vitamin D sufficiency as a potential mitigator in COVID-19 outcomes.

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