Vitamin D levels in post-acute hip fractured patients and their association with rehabilitation outcomes

Abstract

Purpose

To report on serum 25-hydroxyvitamin D (25(OH)D) levels in post-acute hip fractured patients, revealed the associations between serum 25(OH)D levels and hip fractured patients’ baseline characteristics and rehabilitation outcomes.

Materials and Methods

A retrospective study (9/2017-9/2020) of 493 hip fractured patients. 25(OH)D levels were recorded following the patient’s baseline characteristics and outcome measures, including the functional independence measure and motor functional independence measure effectiveness. The sample was divided into three groups: deficient (<30 nmol/l), insufficient (30–75 nmol/l) and sufficient (>75 nmol/l) 25(OH)D levels. ANOVA and chi-square test tests compared the groups. Multiple linear analysis assessed the associations between the 25(OH)D and discharge functional independence measure score.

Results

25(OH)D deficiency was found in 20.3% of the patients. The only baseline characteristic significantly associated with serum 25(OH)D levels was dementia. The group with deficient levels of 25(OH)D exhibited a significantly higher rate of low education, low admission albumin levels and a reduced handgrip strength compared to the insufficient/sufficient groups. All functional measure scores were significantly lower in the deficient (25(OH)D) group compared with the insufficient/sufficient patient groups. 25(OH)D levels were found to be significantly associated with the discharge functional independence measure score.

Conclusions

Routine screening for 25(OH)D levels is mandatory in post-acute hip fracture patients as it may affect rehabilitation outcomes.

Implications for Rehabilitation

• 25-hydroxyvitamin D 25(OH)D levels are associated with rehabilitation outcomes in post-acute hip fractured patients.

• A routine screening for 25(OH)D levels and standardized supplementation protocol during the acute and post-acute rehabilitation setting is recommended as it may improve the quality of care.

Keywords:

• 25-hydroxyvitamin D
• frail
• hip fracture older people
• rehabilitation outcomes
• vitamin D deficiency

Acknowledgements

The authors thank Phyllis Curchack Kornspan for her editorial services.

Authors’ contributions

AH initiated the study, wrote the manuscript, was involved in data collection, and review the literature. GM was involved with data collection, editing the manuscript and review of the literature. RBJ was involved in editing the manuscript and review of the literature. RN assisted in editing the manuscript and review of the literature.

Disclosure statement

No potential conflict of interest was reported by the author(s).