Vitamin D status and complications, readmissions, and mortality after hip fracture.

Autor:	Ingstad, F., Solberg, L. B., Nordsletten, L., Thorsby, P. M., Hestnes, I., Frihagen, F.
Předmět:	RISK of delirium SURGICAL complication risk factors PREVENTION of surgical complications BONE fracture prevention HIP surgery DRUG efficacy CONFIDENCE intervals PATIENT readmissions CHOLECALCIFEROL SURGERY PATIENTS RETROSPECTIVE studies SURGICAL complications VITAMIN D RISK assessment HIP joint injuries DESCRIPTIVE statistics VITAMIN D deficiency LOGISTIC regression analysis ODDS ratio BONE fractures DISEASE risk factors DISEASE complications EVALUATION
Zdroj:	Osteoporosis International; May2021, Vol. 32 Issue 5, p873-881, 9p, 1 Diagram, 5 Charts
Abstrakt:	Summary: Low vitamin D in patients with hip fracture is common. In the present study, 407 of 872 (47%) patients had serum calcidiol less than 50 nmol/L. Patients with low vitamin D had more delirium, more new hip fractures, and more medical readmissions, but not more orthopedic complications after 1 year. Introduction: We wanted to study the relation between vitamin D level and postoperative orthopedic and medical complications in patients with hip fracture. In addition, we investigated the effect of giving a single-dose cholecalciferol 100.000 IU. Methods: Data were taken from the local hip fracture register. Logistic regression analyses including vitamin D level and potentially confounding variables were performed for complications and readmissions. Results: A total of 407 (47%) of 872 included hip fractures had low vitamin D at baseline. A total of 155 (18%) developed delirium, and the risk was higher in vitamin D-deficient patients (odds ratio (OR) 1.48, 95% confidence interval (CI) 1.04 to 2.12; p = 0.03). A total of 261 (30%) were readmitted for non-hip-related conditions. Low vitamin D was associated with a higher risk of medical readmissions within 30 days (OR 1.64 (1.03 to 2.61); p = 0.036) and 12 weeks (OR 1.47 (95% CI 1.02 to 2.12); p = 0.039). There was a higher risk of a new hip fracture (OR 2.84 (95% CI 1.15 to 7.03) p = 0.024) in vitamin D-deficient patients. A total of 105 (12%) developed at least one orthopedic complication, with no correlation to baseline vitamin D. Among vitamin D-deficient patients, those receiving a single-dose of 100.000 IU cholecalciferol had fewer orthopedic complications (OR 0.32 (95% CI 0.11 to 0.97) p = 0.044) the first 30 days after surgery. Conclusion: Low vitamin D at admission for hip fracture increased the risk of delirium, a new hip fracture, and medical readmissions, but not orthopedic complications. The role of vitamin D supplementation to prevent orthopedic complications requires further study. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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