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Preoperative severe vitamin D deficiency is a significant independent risk factor for poorer functional outcome and quality of life 6 months after surgery for fragility hip fractures

D S Sim 1K Tay 2T S Howe 2S B J Koh 2

Osteoporos Int. 2021 May 7. doi: 10.1007/s00198-021-05970-y. 

Abstract

Hip fractures are common in the elderly, and many patients with hip fractures have low vitamin D levels. This study found that severe vitamin D deficiency is linked to poorer recovery of function and quality of life after hip fracture surgery.

Introduction: Vitamin D deficiency is prevalent in hip fracture patients and associated with increased mortality and complications. However, there is limited long-term data on how vitamin D levels affect functional outcomes after hip fracture surgery. The aim of this study is to ascertain the association between vitamin D levels and recovery from hip surgery.

Methods: Patients who underwent hip fracture surgery from January 2012 to December 2016 and had vitamin D levels assessed during admission were included. Retrospective analysis was performed on patients’ demographic data such as age, gender and clinical parameters such as preoperative vitamin D, haemoglobin levels, Charlson Comorbidity Index (CCI), and type and site of surgery. Patients were divided according to four different vitamin D levels-severe vitamin D deficiency (≤10 ng/mL), mild deficiency (10-20 ng/ml), insufficiency (20-30 ng/ml), and normal (>30ng/ml). Functional outcomes were measured by Harris Hip Score (HHS), Parker Mobility Score (PMS), and individual domains of 36-Item Short Form Health Survey (SF36). Univariate and multivariate analyses were conducted to examine the association between vitamin D deficiency and functional outcome scores.

Results: Out of 664 patients identified, 9% had severe vitamin D deficiency and 39% mild deficiency. Patients with severe vitamin D deficiency had significantly poorer baseline and 6-month PMS and SF36 Physical Functioning (PF). In multivariate analysis, severe vitamin D deficiency was associated with lower 6-month PMS and SF36 PF.

Conclusion: Preoperative severe vitamin D deficiency is an independent risk factor for poorer recovery of function and quality of life after hip fracture surgery.